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    Factors influencing recurrent emergency department visits for mild acute respiratory tract infections caused by the influenza virus
    (Peerj Inc, 2023) Tatliparmak, Ali Cankut; Alpar, Suleyman; Yilmaz, Sarper
    Background. Seasonal viral outbreaks, exemplified by influenza A and B viruses, lead to spikes in emergency department (ED) visits, straining healthcare facilities. Addressing ED overcrowding has become paramount due to its implications for patient care and healthcare operations. Recurrent visits among influenza patients remain an underexplored aspect, necessitating investigation into factors influencing such revisits.Methods. Conducted within a tertiary care university hospital, this study adopts an observational retrospective cohort design. The study included adult patients with acute respiratory symptoms diagnosed with influenza using rapid antigen testing. The cohort was divided into single and recurrent ED visitors based on revisits within 10 days of initial discharge. A comparative analysis was performed, evaluating demographics, laboratory parameters, and clinical process data between recurrent visitors and single visitors.Results. Among 218 patients, 36.2% (n = 139) experienced recurrent ED visits. Age and gender disparities were not significant. Antibiotics were prescribed for 55.5% (n = 121) and antivirals for 92.7% (n = 202) of patients, with no notable influence on recurrence. Recurrent visitors exhibited lower monocyte counts, hemoglobin levels, higher PDW and P-LCR percentages, and increased anemia prevalence (p = 0.036, p = 0.01, p = 0.004, p = 0.029, p = 0.017, respectively). C-reactive protein (CRP) levels did not significantly affect recurrence.Conclusion. This study highlights the pressing concern of recurrent ED visits among mild influenza patients, magnifying the challenges of ED overcrowding. The observed notable prescription rates of antibiotics and antivirals underscore the intricate land-scape of influenza management. Diminished monocyte counts, hemoglobin levels, and altered platelet parameters signify potential markers for identifying patients at risk of recurrent visits.
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    Predictive Parameters for Hospital Admission Among Liver Transplant Recipients Presenting to the Emergency Department: A 5-Year Study
    (Galenos Publ House, 2024) Aydin, Omerul Faruk; Gulec, Tolgahan; Tatliparmak, Ali Cankut; Yilmaz, Sarper
    Aim: Liver transplantation (LT) has significantly improved patient outcomes, leading to increased numbers of LT recipients seeking emergency department (ED) care. However, there is a lack of comprehensive information regarding their outcomes and parameters influencing hospital admission decisions. This study aims to address the gap in knowledge by analyzing critical parameters influencing hospital admission decisions for LT recipients presenting at the ED. Materials and Methods: A retrospective observational case-control study was conducted with 247 consecutive LT patients who visited a tertiary care center's ED between 2018 and 2023. Demographic information, transplantation details, presenting complaints, laboratory results, and ED outcomes were evaluated. Univariate analysis identified significant predictors for an artificial neural network (ANN) analysis to predict admission decisions. Results: Among 247 LT recipients presenting at the ED, 48.2% were admitted. The most common complaints among admitted patients were abdominal pain and fever. Patients admitted had higher levels of alanine aminotransferase, aspartate aminotransferase (AST), alkaline phosphatase, gamma-glutamyl transferase, and C-reactive protein (CRP) and lower levels of total protein and albumin compared to discharged patients. Ultrasonography findings of perihepatic fluid collection were more common in admitted patients. The ANN analysis identified total protein, conjugated bilirubin, CRP, total bilirubin, and AST as the most influential factors predicting hospital admission decisions. Conclusion: The ANN analysis identified total protein, conjugated bilirubin, CRP, total bilirubin, and AST influencing hospital admission decisions for liver transplant recipients in the ED. Emphasizing the significance of these parameters can guide evidence-based guidelines for improved patient care and resource allocation in emergency settings.
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    A shortcut for preparing doses of positive inotropic drug infusions in emergency patient management-fast inotrope bag (FiB) coefficient''
    (Mre Press, 2023) Alpar, Suleyman; Yilmaz, Sarper; Ak, Rohat
    The most basic rule for the management of patients in the emergency departments (EDs) and critical & intensive units (ICUs) are quick decision and quick order medication. For this reason, calculator applications are a necessary part of EDs in order to calculate some drug doses quickly. With the simple formula we discovered, it will be much easier to place an order for the 4 most frequently used drugs of the EDs (dopamine, dobutamine, norepinephrine, epinephrine). We recommend this simple and fast calculation method to all EDs and ICUs with fast inotrope bag (FiB) coefficient. This coefficient has been developed especially for simple pump devices or dosing devices that do not use ready-made inotropic drug bags and that, if needed, first control the preparation of the solution and then the hourly infusion of the prepared solution. These devices are used only because the amount of solution to be given to the patient per hour can be monitored. Taking advantage of this coefficient, the inotrope needed by the patient can be administered easily and quickly with only the patient's weight information, and the initial dose corresponds to the dose range recommended by the guidelines for inotropes.