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    The Role of Lactate and Troponin-I Levels in Predicting Length of Hospital Stay in Patients with Carbon Monoxide Poisoning
    (Clin Lab Publ, 2019) Güzel, Murat; Atay, Erdi; Terzi, Özlem; Demir, Mehmet Cihat; Erenler, Ali Kemal; Demir, Mehmet T.
    Background: Carbon monoxide (CO) is one of the most common causes of unintentional poisonings resulting in death. Patients with more severe findings such as loss of consciousness and persistent neurological or cardiovascular dysfunction require hospitalization. Although there are clinical findings which determine hospitalization criteria in patients presenting with CO poisoning, there is some ambiguity regarding laboratory biomarkers which determine length of hospital stay (LOS) in these patients. In this study, we aimed to identify the effectiveness of initial blood gases and biochemical parameters in predicting LOS in patients presenting to the emergency department with CO poisoning by retrospective analysis of medical records. Methods: This study was conducted in the Emergency Department (ED) of Samsun Training and Research Hospital by analyzing from medical records retrospectively of 275 patients who were admitted to the hospital following acute CO poisoning between January 2014 and July 2017. The patients were divided into 3 groups according to LOS: Group I, patients with LOS < 24 hours; group II, those with LOS > 24 hours and < 3 days; and group III, those with LOS > 3 days. Results: In comparisons regarding lactate and troponin-I, it was found that there were significant differences in both parameters among the three groups (p = 0.000) and that both lactate and troponin-I levels were higher in group III than groups I and II, with group I being lowest (group III > group II > group I). While there was a moderate positive statistically significant correlation between LOS and lactate (r: 0.43, p = 0.001) and troponin (r: 0.31, p = 0.001), a weak positive correlation was determined with CK (r: 0.19, p = 0.04). In this study, it was found that lactate and troponin-I values were more effective in predicting LOS when compared to carboxyhemoglobin levels and other biochemical parameters. Conclusions: The results of this study may guide clinicians to predict LOS in patients who present with CO poisoning and have high troponin-I and lactate levels at the time of admission to EDs.
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    Öğe
    Value of pulmonary vascular obstruction index for determining thrombolytic therapy
    (Carbone Editore di Alessandro Pennino, 2016) Güzel, Murat; Soylu, Ayşegül İdil; Salt, Ömer; Erenler, Ali Kemal; Tomak, Leman; Arslan Aksu, Esra; Atay, Erdi; Baydın, Ahmet
    Introduction: An index for Pulmonary Artery Computed Tomography Index Ratio (PACTOIR) may have important prognostic and therapeutic implications and as well as providing a standard to evaluate thrombolytic therapy response. The aim of this study was to determine whether PACTOIR predict the thrombolytic therapy in the treatment of pulmonary embolism (PE). Materials and methods: This retrospective study was conducted by reviewing charts of 52 patients (aged =18 years) who were admitted to our emergency department (ED) with initial diagnosis of pulmonary embolism and confirmed diagnosis of PE by Computed Tomography Pulmonary Angiography (CPTA). The patients were divided into two groups as follows: Group 1 (n=14) consisted of the patients who received thrombolytic therapy and Group 2 (n=38) consisted of the patients who did not receive thrombolytic therapy. PACTOIR was calculated in both groups to estimate thrombus load. We evaluated the effectiveness of thrombolytic therapy by comparing the levels of D-dimer and Troponin I. Results: Mean value for PACTOIR, D-dimer and Troponin I levels were 56.4 (%), 6.21 (mg/L) and 0.35 (?g/L) in Group 1 whereas they were 20.46 (%), 2.20 (mg/L) and 0.11 (?g/L) in Group 2, respectively. Significant difference was detected between Group 1 and Group 2 (p < 0.001). The sensitivity and specificity values were calculated as 92.9% and 89.5% for PACTOIR, whereas they were 85.7% and 78.9% for D-dimer, respectively. These values were found to be 78.6% and 65.8% for Troponin I, respectively. Conclusion: Based on our results, sensitivity to show PE severity and to determine thrombolytic therapy was significant when compared to D-dimer and Troponin I. In addition, we concluded that PACTOIR is the parameter with greatest sensitivity in determining the effectiveness of thrombolytic therapy.