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Öğe The evaluation of the sensitivity and specificity of wrist examination findings for predicting fractures(W B Saunders Co-Elsevier Inc, 2018) Eyler, Yesim; Sever, Mustafa; Turgut, Ali; Yalcin, Necmiye; Zafer, Nur; Suner, Asli; Aksay, Ersin; Yesilaras, MuratBackground: The aim of this study was to evaluate the sensitivity and specificity of physical examination findings and functional tests in adult acute wrist trauma patients who presented to the emergency department (ED) and to create a reliable and practical clinical decision rule for determining the necessity of radiography in wrist trauma. Methods: This prospective observational study was conducted in a tertiary ED. Each patient was checked for 18 physical examination findings and functional tests. Patients with suspected fracture were enrolled consecutively. Antero-posterior and lateral wrist views were performed for each patient. All radiographical studies were interpreted by an orthopedic surgeon. The prevalence, sensitivity and specificity, negative and positive predictive values of each finding were calculated. A modeling for predicting fractures was created using computer. Results: 207 patients were evaluated and 69 patients (33.3%) had fractures. The most common encounterd fracture site was distal radius (29.5%). The most sensitive examination finding was pain in dorsiflexion (95.7%) and the most specific finding was ecchymosis (97.8%). Wrist edema, deformity and pain aggravated by pronation were found to be strong predictors of fracture. The area under the receiver operating characteristic curve at internal validation for a prediction model based on these three predictors was 0.88 (95% CI: 0.83-0,93). The overall sensitivity and specificity of this model were 94% (95% CI: 85-98%) and 51% (95% CI 43-60%) respectively. According to the model created in this study, 34% of acute blunt wrist trauma patients do not require any X-ray imaging. Conclusions: This triple modeling may be used as an effective decision rule for predicting all wrist fractures in the ED and in the disaster setting. (c) 2017 Elsevier Inc. All rights reserved.Öğe The evaluation of the sensitivity and specificity of wrist examination indings for predicting fractures (vol 36, pg 425, 2018)(W B Saunders Co-Elsevier Inc, 2022) Eyler, Yesim; Sever, Mustafa; Turgut, Ali; Yalcin, Necmiye; Zafer, Nur; Suner, Asli; Aksay, Ersin[No Abstract Available]Öğe The Relation of End-Tidal CO2 Values With Infarct Volume and Early Prognosis in Patients With Acute Ischemic Stroke(Lippincott Williams & Wilkins, 2022) Eyler, Yesim; Kilic, Turgay Yilmaz; Atilla, Ozge Duman; Arslan, Yildiz; Capar, Ahmet Ergin; Idil, Hasan; Suner, AsliBackground: The aim of this study is to reveal the relationship between end-tidal CO2 (EtCO2) values with infarct volume and early prognosis in patients diagnosed with acute ischemic stroke in the emergency department. Materials and Methods: This prospective cross-sectional study was conducted in a tertiary hospital. The demographics, characteristics, EtCO2, volume of the stroke area on diffusion-weighted magnetic resonance imaging and the modified Rankin Scale (mRS) of the patients were recorded. The values calculated at admission and at discharge were labeled as mRS-1 and mRS-2, respectively, and the mRS-2 measurement was used as a prognostic indicator. The good and the poor functional outcomes were defined as mRS <= 2 and mRS >2, respectively. Correlations between levels of EtCO2 and infarct volume, mRS were calculated. Results: In total, 44 patients were included in the study. The median age of the patients was 69 years (interquartile range; 16; min-max: 35 to 88 y) and 68.2% of them were male. In the univariate logistic regression models of the mRS-2 [0 to 2 (0) and 3 to 6 (1)], all variables were not statistically significant to predict mRS-2 group. There were statistically significant differences in EtCO2 values between mRS-1 (P=0.03) and mRS-2 (P=0.04). A negative moderate correlation was found between EtCO2 and mRS-2 (r=-0.410; P=0.006). The correlation between EtCO2 and infarct volume was not statistically significant (r=-0.256; P=0.093). Conclusions: This study highlights the importance of capnography follow-up of patients with acute ischemic stroke. In patients with acute ischemic stroke, the EtCO2 value measured at the time of admission is lower in the group with high mRS at both admission and discharge.Öğe A study to develop clinical decision rules for the use of radiography in wrist trauma: Karadeniz wrist rules(W B Saunders Co-Elsevier Inc, 2018) Sever, Mustafa; Eyler, Yesim; Suner, Asli
