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Objective: Hip fractures are an important health problem in geriatric patients. Preoperative estimation of mortality risk can be done by assessing malnutrition, establishing a perioperative treatment plan, determining the prognosis, and reducing morbidity and mortality. The prognostic nutritional index (PNI) is a simple, cost-effective, and easily applicable indicator of nutritional status in patients. This study aimed to determine the relationship between preoperative PNI and postoperative mortality in patients with hip fracture. Materials and Methods: This prospective observational study included 183 patients aged 65-95 years who had I-IV American Society of Anesthesiologists physical status and were operated within the first 48 h after hip fracture. Patients were divided into two groups according to the 37.25 cutoff value of PNI. In total, 172 patients completed the study, of which 53 were in the low PNI group and 119 in the high PNI group. Results: The length of hospital stay, postoperative delirium, and 3-month mortality were significantly higher in the low PNI group than in the high PNI group (p=0.035, p=0.001, p=0.0001, respectively). Conclusion: Using PNI for diagnosing malnutrition in patients with hip fractures can help create an optimized treatment plan and reduce mortality. PNI is an easily calculated, objective, and inexpensive biomarker that can be used in routine screening.

In this study, we evaluate 25 cases who were admitted to the emergency service and transferred to the intensive care unit subsequently due to snakebite, prospectively. Clinical courses, toxic effects, complications and treatment approaches were aimed to be presented. Among the patients, 16 were female and 9 were male; the mean age was 42.1 (17-74 years). It was determined that all the cases were admitted to the hospital during working in the field in Eastern Anatolia Region, between the months of May and June, and between the hours of 15:00 to 18:00. When the cases were considered in terms of bitten body part, 15 were bitten from upper extremity and 10 were bitten from lower extremity. Within an hour the patients were admitted to a health facility with the complaints of nausea, pain, numbness, swelling and redness, and patients were transferred to emergency unit approximately within 1 hour (0.5 to 2 hours) following the first intervention. Tetanus immunization is administered in all cases as the first intervention. Antivenom was administered to the 9 (36%) of the patients in whom steroid, antihistamine and prophylactic antibiotic therapy was given in the intensive care unit. Under the control of infection clinic, antibiotic therapy was initiated to 13 (52%) patients in who cellulitis, abscess, lymphedema and compartment syndrome were developed. Healing was observed approximately within 4 days (2-6 days) and recovery was observed in all the cases. Patients admitted due to snake bites should be followed closely for at least 6 to 8 hours. According to the patient’s clinical condition and laboratory test results, early intervention therapy should be regulated and antivenom therapy should be administered in the presence of systemic symptoms.