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    A Rare Cause of the Emergency Department Visit: Internal Jugular Vein Thrombosis
    (Emergency Medicine Physicians Assoc Turkey, 2021) Akdur, Gokhan; Bardakci, Okan; Akdur, Okhan; Das, Murat; Atalay, Unzile
    Introduction: Detection of the internal jugular vein thrombus (IJVT) in the Emergency Department with bedside ultrasonography is not common. Case Report: A 43 years old male patient was admitted to our emergency department with the complaint of pain, swelling and redness on the left side of the neck, which was noticed after chemotherapy 1 day ago. The swelling and redness of the hand, starting from the left clavicle and extending to the corner of the left mandible, were detected in the physical examination of the patient. The patient underwent bedside ultrasonography imaging by the emergency medicine specialist. Ultrasonography examination of the patient was performed with 5-12 MHz linear probe. After visualization of the vascular structures carotid, vascular structures were observed in the sagittal and longitudinal plane by gradual compression. Hyper echoic thrombus was seen in the incompressible internal jugular vein. Conclusion: IJVT can lead to complications such as pulmonary embolism, septic embolism, cerebral venous thrombosis. These complications may decrease with early diagnosis and treatment. It is a rare condition in IJVT Emergency Services. The increasing use of bedside ultrasonography by emergency physicians will prevent possible complications that will enable these patients to be easily diagnosed and successful treatments in recent years.
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    Prediction of adverse outcomes using non-endoscopic scoring systems in patients over 80 years of age who present with the upper gastrointestinal bleeding in the emergency department
    (Turkish Assoc Trauma Emergency Surgery, 2022) Bardakci, Okan; Siddikoglu, Duygu; Akdur, Gokhan; Simsek, Guven; Atalay, Unzile; Das, Murat; Akdur, Okhan
    BACKGROUND: The emergency department (ED) admission rate for elderly patients with non-variceal upper gastrointestinal bleeding (UGIB) is increasing. The AIMS65 and Glasgow-Blatchford score (GBS) are two distinct scoring systems proposed to predict in-hospital and post-discharge mortality, length of stay (LOS), and health-related costs in these patients. The objective of the present study is to evaluate the accuracy of these scoring systems, in conjunction with the Charlson comorbidity index (CCI), to predict 30-day mortality and LOS in UGIB patients who are 80 years of age or older METHODS: A retrospective analysis was undertaken of 182 patients with non-variceal UGIB who were admitted to the ED of Canakkale Onsekiz Mart University Hospital. The AIMS65, GBS, and CCI scores were calculated and adverse patient outcomes were assessed. RESULTS: The mean age of patients was 85.59 +/- 4.33 years, and 90 (49.5%) of the patients were males. The AIMS65 was superior to the GBS (area under the receiver operating characteristic curve [AUROC] 0.877 vs. 0.695, respectively) and CCI (AUROC 0.877 vs. 0.526, respectively) in predicting the 30-day mortality. All three scores performed poorly in predicting the LOS in hospital. The cutoff threshold that maximized sensitivity and specificity for mortality was three for the AIMS65 score (sensitivity, 0.87; specificity, 0.80; negative predictive values [NPV], 0.977; positive predictive values [PPV], 0.392), 14 for GBS (sensitivity, 0.83; specificity, 0.51; NPV, 0.923; PPV, 0.367), and 5 for CCI (sensitivity, 0.91; specificity, 0.22; NPV, 0.946; PPV, 0.145). CONCLUSION: The AIMS65 is a simple, accurate, and non-endoscopic scoring system that can be performed easily in ED settings. It is superior to GBS and CCI in predicting 30-day mortality in elderly patients with UGIB.