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Background/Aims: This single-center study aimed to investigate the clinical outcomes and midterm mortality in patients who underwent carotid endarterectomy (CEA) for various indications. Methods: The study included 109 patients who underwent CEA at our institution. Demographic characteristics, indications for surgery, operative techniques, and early postoperative complications were recorded. Follow-up data were obtained for a mean period of 23.3 ± 17.2 months, and mortality causes, and neurological outcomes were analysed. Results: The mean age of the patients was 66.53 ± 8.00 years, with 73 men and 36 women. Indications for CEA included transient ischemic attack (TIA) in 21.1% and a history of ischemic stroke in 26.6% of patients. Overall, 86.2% had ipsilateral carotid stenosis of 70% or more. Most patients (89.9%) were operated under general anesthesia, and the conventional carotid endarterectomy technique was most employed (78.0%). The most frequent reconstruction method for the longitudinal carotid arteriotomy was Dacron patch plasty (56.0%). Early follow-up revealed low hospital mortality (0.9%) and limited postoperative complications (3.7% TIA, 1.8% major neurological complications, and 1.8% minor neurological complications). During the follow-up period, absolute survival was 87.0%. Conclusions: Our study demonstrates favourable early outcomes and acceptable long-term mortality rates following CEA. However, larger, and multicentre studies are warranted to further validate these results and enhance our understanding of CEA's long-term benefits

Objective: Hip fracture is a condition frequently encountered in geriatric patients and is correlated with high postoperative mortality and morbidity. Numerous factors may impact mortality, but recent studies have focused on its correlation with inflammation. The neutrophil-to-platelet ratio has been evaluated as a systemic inflammation marker. The aim of our study was to examine the correlation between preoperative neutrophil-to-platelet ratio (NPR) values and postoperative one-year mortality in geriatric patients with hip fractures. Material and Method: In our retrospective, multicenter study, 50 patients over 65 years of age who had undergone hip fracture surgery under spinal anesthesia were examined. Patients’ preoperative neutrophil-to-platelet ratio values at the time of hospitalization, age, gender, American Society of Anesthesiologists scores, fracture types, comorbidities, durations of surgery, lengths of hospital stay, and survival in the postoperative one-year period were checked. Results: The mean age of all the patients was 85.44 ± 6.93 years. Of the patients, 60% were female (n = 30), and 40% were male (n = 20). The optimal cut-off value for preoperative neutrophil-to-platelet ratio was specified as 38.286. The length of hospital stay was 8.94 ± 3.05 in the deceased patients and 6.94 ± 2.63 days (p = 0.02) in the surviving group. The mortality rate was higher in men than in women (p = 0.01). Conclusion: A preoperative neutrophil-to-platelet ratio value over 38.286 is an indicator of postoperative one-year mortality in elderly hip fracture patients. Additionally, length of hospital stay and the male gender were revealed to be correlated with mortality.

Handgrip strength is a quick way to assess overall muscle strength. Low handgrip strength is an indicator of poor health. While handgrip strength is related with mortality and morbidity, for some parameters, handgrip strength is even a stronger predictor of health than chronological age alone. Handgrip strength is highly sexually dimorphic and has a high heritability. It is thought that this is an outcome of sexual selection and intrasexual competition in our evolutionary history. Some anthropological studies confirm this view, and it is claimed that there are relationships between grip strength and aggression, athletic performance and attractiveness, especially in men. The aim of this study is to review the relationship of diseases with handgrip strength in anthropological perspective and examine the idea that handgrip strength being a marker of biological fitness.

Background/Aims: The MELD score is a scoring system used to assess the severity of end-stage liver disease. In our study, we aimed to investigate the role of MELD score in predicting the course of the disease and mortality in COVID-19 disease with multi-systemic involvement. Methods: Our study was conducted with 96 patients over the age of 18 who were diagnosed with COVID-19 by real time PCR method by taking nasopharyngeal swabs between March 2021 and March 2022. MELD score was calculated according to the blood results of the patients at the time of hospital admission. To calculate the MELD score, the equation MELD = 11.2 x ln(international normalized ratio [INR]) + 3.78 x ln(bilirubin, mg/dL) + 9.57 x ln(creatinine, mg/dL) + 6.43 was used. Results: We found that the MELD score was significantly higher in the moderate and severe patient group compared to the mild patient group (p

Many questions remain unanswered regarding the so-called “Spanish” influenza pandemic of 1918. This article addresses three of them and describes the state of knowledge for each of them: Where did the pandemic start? How many people died? And why was it so deadly?

Au Congo, la nécessité d’un cadre juridique protecteur de la femme enceinte est une préoccupation. En effet, le risque que court une femme de mourir ou de devenir invalide durant la grossesse et l’accouchement est en rapport étroit avec son statut social et économique, les normes et valeurs de la culture à laquelle elle appartient et le fait de résider dans un lieu géographique reculé. De manière générale, plus une femme est pauvre et marginalisée, plus son risque de mourir est grand. En fait, les taux de mortalité maternelle reflètent les inégalités entre pays riches et pays pauvres dont fait partie le Congo, plus qu’aucune autre mesure d’ordre sanitaire. Ici, le risque d’une femme, calculé sur la durée de vie, de mourir du fait de la grossesse ou de l’accouchement est de 1 sur 39 contre 1 sur 4 700 dans les pays développés.

Background and Aim: Predicting high-risk patients is crucial in acute myocardial infarction (AMI). We aimed to investigate whether the leukoglycemic index (LGI) has a unique ability and to compare it with other inflammatory parameters in predicting in-hospital mortality in AMI. Methods: In this single-center study, we retrospectively analyzed all AMI patients hospitalized and followed by a single operator. Patients were divided into two according to in-hospital outcomes. Other inflammatory parameters (systemic immune-inflammatory index, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, triglyceride-HDL ratio, and LDL-HDL ratio), C-reactive protein (CRP), and LGI were calculated according to previously described criteria. Univariable and multivariable logistic regression analyses were used to find independent predictors. The receiver operating characteristic (ROC) curve was used to find the cut-off point of LGI and other parameters in predicting mortality. Results: A total of 304 patients with AMI were included in the study. The mean age was 62.18±11.89 and 74 (24.3%) of patients were female. The total death rate was 19 (6.3%). In univariate variable analysis, LGI was found as a significant predictor of mortality (p

Aim: COVID-19 can cause clinical pictures ranging from asymptomatic to severe respiratory failure and sudden death. The severity of the disease varies depending on many factors such as comorbidity, vaccination status, as well as demographic characteristics such as age and gender. In this study, it was aimed to investigate the independent risk factors that have an effect on mortality in COVID-19 patients. Materials and Methods: In the study, records of 140 patients with a diagnosis of COVID-19 followed in the intensive care unit between 01.01.2021 and 01.01.2022 were examined. Demographic characteristics such as age and gender, comorbidity, vaccination status and clinical course of the patient were investigated and recorded. Results: In our study, a statistically significant difference was found between mortality and age, and the number of days of total invasive/noninvasive mechanical ventilation support (p=0.01, p=0.25, p

Objective: Acute kidney injury (AKI) has been reported in patients with COVID-19 pneumonia and associated with higher mortality. Our study aimed to determine the relationship of eGFR during admission to the intensive care unit with mortality and clinical outcomes in the elderly COVID-19 patients. Material and Method: This study in which the elderly patients were included was retrospectively performed in a single-center intensive care unit (ICU). Results: A total of 152 patients including 75 female and 77 male patients were included in the study. Mean age of the patients was 74.3±7.3 years. The number of patients was 92 (60.5%) in eGFR Stage 1-2, 15 (9.9%) in Stage 3a, 26 (17.1%) in Stage 3b, and 19 (12.5%) in Stage 4-5. The rate of patients who received invasive mechanical ventilation was 40.8% and hospital mortality rate was 48.7%. According to the multivariate logistic regression analysis, eGFR, LDH, Charlson score, and duration of stay in the intensive care unit were effective on mortality. Compared to eGFR Stage 1-2 patients, the mortality risk was 4.836 times higher in Stage 3a patients, 12.233 times higher in Stage 3b patients and 10.242 times higher in Stage 4-5 patients. Conclusion: Our results revealed that COVID-19 patients’ eGFR during admission to the intensive care unit, LDH, Charlson score, and duration of stay in the intensive care unit were effective on mortality.

Objective: Cardiopulmonary arrest is the condition of insufficient oxygen delivery to tissues as a result of sudden cessation of circulatory and respiratory functions. This study aimed to investigate the causes of arrest in patients admitted with cardiopulmonary arrest and the effect of initial cardiac rhythm on patient survival. Material and Methods: Out of 1126 patients who had an in-hospital and out-of-hospital cardiac arrest and were admitted to our emergency department, 1009 patients were included in this retrospective study following the exclusion criteria. In addition to the demographic characteristics of patients, their initial rhythms and mortality states were assessed. Results: There was a significant relationship between patients’ clinical outcomes and initial cardiac rhythms (p

Aim: The incidence of adverse postoperative outcomes in surgeries for femur fractures is high and is associated with malnutrition. In this study, it was aimed to determine the independent factors for 6-month survival in patients with femur fracture and to evaluate the predictive value of the prognostic nutrition index (PNI). Material and Method: One hundred and sixteen patients operated on only for femoral fracture were divided into survival and non-survival groups according to mortality.Demographic characteristics of the patients, operation data, fracture sites, need for intensive care unit and length of stay, postoperative hospital stay, and preoperative laboratory values, prognostic nutrition indices and mortality were evaluated. Results: Twenty-six (22.4%) of 116 patients who were operated for femoral fracture resulted in 6-month mortality. CRP, albumin, prealbumin, crp/albumin ratio and PNI values at admission were independent risk factors for postoperative mortality (p=0.014, p

Objective: We aimed to determine the main demographic features of COVID-19, reveal the clinical differences to patients in other countries, evaluate severe adverse effects in terms of number and types of comorbidities, and provide information about prognosis possibilities. Materials and Methods: Patients’ records, followed at Sakarya University Hospital between late March 2020 and late April 2020 with a diagnosis of COVID-19, were evaluated for this study. Demographic features were noted retrospectively with records, and data were recorded in the MS Excel program for analysis with SPSS. Statistical significance was set at p lt; 0.05. Results: The records of 1443 cases, 704 (48.8%) women and 739 (51.2%) men, a mean age of 44.98 ± 18.72, were examined retrospectively. Among them, 9.9% were medical staff, 1.8% had a history of travel abroad, and 1.1% were pregnant. Radiological findings of 59.4% of our polymerase chain reaction (PCR) positive patients were compatible with COVID. The mean length of hospital stay was 4.5 days. Frequent comorbidities were hypertension, diabetes (DM), and ischemic heart disease. Eighty (5.5%) patients treated in intensive care (ICU) died. Conclusion: Based on the data of 1443 patients, the mean length of hospitalization of COVID-19 patients was 4.5 days, or followed up in intensive care, having DM and a long period of hospitalization, which increased mortality risk. None of the outpatients died.

Aim: Coronavirus disease 2019 (COVID-19) mostly proceeds with mild respiratory symptoms, but sometimes severe pneumonia, cytokine storm, and acute respiratory distress syndrome can develop. Anti-cytokine treatments are being tried for cytokine storm. In this study, we aimed to examine the effect of tocilizumab on mortality associated with COVID-19. Material and Methods: The study included 146 patients with moderate-to-severe acute respiratory distress syndrome diagnosed with COVID-19. The patients were divided into two groups, receiving only standard treatment (ST group, n=44), and tocilizumab treatment in addition to standard treatment (TCZ group, n=102). Groups were compared in terms of demographic, clinic, and laboratory data. Also, mortality rates were determined to detect the effect of tocilizumab on mortality. Results: Overall, 36.3% (n=53) of the patients were female, 63.7% (n=93) were male, and the mean age was 69.5±14.2 years. The mortality rate was 29.4% (n=30) in the TCZ group and 52.3% (n=23) in the ST group (p=0.009). While C-reactive protein, fibrinogen, and lactate levels on admission to the intensive care unit (ICU) were similar across the groups, the TCZ group had higher ferritin levels (p=0.006). On discharge from ICU, the TCZ group had a significant decrease in C-reactive protein (p

Aim: Anemia is associated with increased mortality and morbidity in all patients undergoing surgery. This study aimed to reveal to what extent anemia caused postoperative complications before hiatal hernia surgery. Material and Methods: One hundred and ninety-two patients operated for hiatal hernia in our clinic between 2015 and 2019 were analyzed retrospectively. Patients were compared according to demographics, preoperative laboratory values, preoperative Charlson comorbidity index score, hiatal hernia type, postoperative intensive care requirement, presence of postoperative complications, Clavien-Dindo score, blood transfusion need, and length of hospital stay. Results: Of the patients, 109 were female and 83 were male. The mean age was 50.1±9.1 years. Fifty-four (28.2%) of the patients were in the anemic group, and 138 (71.8%) were in the non-anemic group. There was no statistically significant difference between the groups in terms of gender distribution (p=0.663). When the groups were compared in terms of age distribution, it was found that the anemic group was older than the non-anemic group and the difference was statistically significant (p

Aim: Liver dysfunction is an early finding caused by the inflammation and hypoperfusion developed in sepsis. Magnesium deficiency may contribute to an excessive response to immune stress and inflammatory tissue damage in sepsis. This study aimed to evaluate the relationship between serum magnesium levels and early liver dysfunction (ELD) in patients with sepsis. Material and Methods: 142 patients who developed sepsis were divided into two groups according to their liver function, as sequential organ failure assessment (SOFA) hepatic subscore

Aim: Systemic immune-inflammation (SII) index may provide more promising prognostic information in patients with cancer surgery. However, to the best of our knowledge, the prognostic value of SII index in patients with pancreatic cancer who underwent pancreaticoduodenectomy has not been studied. Thus, this study aimed to evaluate and compare the prognostic value of SII index in patients with pancreatic cancer who underwent pancreaticoduodenectomy. Materials and Methods: All patients over 18 years-old that underwent successful pancreaticoduodenectomy due to pancreatic cancer between February 20, 2019 and June 30, 2021 at Ankara City Hospital Department of General Surgery were included. The main predictor of interest was SII index which was measured by neutrophil*platelet / lymphocyte count. The main outcome of the study was long-term all-cause mortality. Results: A total of 223 patients were included in the current study. Multivariable cox regression analysis revealed that history of congestive heart failure [HR (95%CI): 3.682 (1.140-11.892)], and SII index [HR (95%CI): 1.001 (1.001-1.001)] were independently associated with all cause long-term mortality. The accuracy of predicting mortality for SII index was assessed by the area under the ROC curve which was = 0.77. A higher value of 1305 of SII index was found with 76% sensitivity and 67% specificity for predicting all-cause long-term mortality. Conclusions: The results of the study suggest that measurement of the SII index, an easily available and relatively cheap marker, is an independent predictor of long-term survival after pancreaticoduodenectomy in patients with pancreatic cancer.

Bu çalışma iki 5-(3'-amino-4'-arilazo-1H-pirazol-5'-ilazo) barbitürik asit boyasının (Boya 1 ve Boya 2) ekotoksikolojik çalışmalarda model organizma olarak bilinen Chironomus riparius (Diptera: Chironomidae) üzerindeki mortalite etkisinin ve akut toksisitesinin incelenmesi amacıyla yapılmıştır. Detaylı mortalite değerlendirmelerinden sonra Boya 2’nin organizmalar üzerinde Boya 1’e kıyasla daha fazla mortalite etkisine sebep olma potansiyeline sahip olduğu ve sucul ekosistemlerde yüksek konsantrasyonlarda uzun süreli bulunmasının bu ekosistemler için kayda değer bir tehdit oluşturabileceği sonucuna varılmıştır. Gerçekleştirilen toksisite sınıflandırmasında Boya 1’in, 24 ve 48 saat maruziyetlerde pratikte toksik değilken 72 ve 96 saat maruziyetlerde hafif derecede toksik olduğu, Boya 2’nin ise 24 saat maruziyette pratikte toksik değilken 48, 72 ve 96 saat maruziyetlerde hafif derecede toksik olduğu bulunmuştur. Mortalite etkisi ve toksisitedeki bu farklılıkların boya yapısında bulunan sübstitüentlerin farklı olmasından kaynaklanabileceği söylenebilir. Bu çalışma, yapısında metoksi ve metil grubu içeren azo boyaların (sırasıyla Boya 1 ve Boya 2) C. riparius üzerindeki mortalite etkisi ve akut toksisitesi ile ilgili önemli bilgiler sunmaktadır. Ancak daha kapsamlı ekotoksikolojik değerlendirmeler yapabilmek için bu ve benzeri azo boyaların ve bozunma ürünlerinin farklı organizmalar üzerindeki etkilerinin ve etki mekanizmalarının moleküler düzeyde incelendiği ve sucul ortamlardaki gerçek konsantrasyonlarının belirlendiği daha ileri çalışmalara ihtiyaç olduğu bir gerçektir.

Amaç: 2019 aralık ayında başlayan Sars-Cov-2 adı verilen koronavirüs ailesine ait olan koronavirüs nedeniyle mart 2020 ayında tüm dünyada pandemi ilan edildi ve virüsün yol açtığı hastalık Covid-19 olarak anılmaya başlandı. Yaklaşık 176.000.000 kişiyi etkileyen pandemide 12/06/21 tarihi ile 3.500.000 dan fazla insanın vefat ettiği bildirilmiştir. Hipertansiyon tanısı olan hastalarda Covid-19 hastalarında ölüm oranlarının, hastane yatışlarının ve gelişen diğer komorbiditelerin daha fazla olduğu bilinmektedir. CRP, fibrinojen, D-dimer gibi laboratuvar değerlerinin Covid-19 için hastalık ilerleyişini belirlemede önemli olduğu da bilinmektedir. Bu çalışmamızda kliniğimizde Covid-19 nedenli takip edilen hipertansiyon tanısı olan hastaların hastane başvurusu anında bakılan Fibrinojen, Crp, D-dimer gibi Covid-19 için hastalık progresyonu belirteçlerinin hipertansiyonu olmayan hastalara kıyasla farklı olup olmadığı ve hipertansif Covid-19 hastalarında hastalık gidişatını belirlemek için bu parametrelerin kullanımının klinik fayda sağlayıp sağlamadığını belirlemeyi amaçladık Gereç ve Yöntem: İç hastalıkları kliniği servis ve yoğun bakımlarında 15/03/2020 ile 15/01/2021 tarihleri arasında Covid-19 nedenli takip edilen 590 hastanın verileri geriye dönük olarak incelendi. Hastaların yaşı cinsiyeti gibi demografik verileri ile beraber laboratuvar değerleri hastane otomasyon sisteminden tarandı. Veriler SPSS programına kaydedildi ve istatistiksel analizler yapıldı. Hastalar ölüm ve şifa sağlanan hastalar olarak 2 grupta incelendi. Bulgular: Hipertansiyonu olan hastaların ortalama yaşlarına bakıldığında 69,77±17,5 (n:310) iken hipertansiyonu olmayan hastaların yaş ortalaması 61,04±10,6 (n:280) olarak saptandı (p:0,000). Hipertansiyonu olan hastalarda D-dimer düzeylerine bakldığında 1270 (37-20200) n:295 ugFEU/L iken hipertansiyonu olmayan hastalarda 875(4-38800) n:266 (p:0,009) olarak görülmüştür. Fibrinojen düzeyleri ise hipertansif olan hastalarda 434,6±143,9 mg/dl n:279 iken hipertansif olmayan hastalarda 403,6±135,7 mg/dl n:240 (p:0,012) olarak saptanmıştır. Sonuç: Hipertansiyon tanısı olan Covid-19 hastalarında yüksek fibrinojen ve D-dimer düzeyleri kötü prognostik faktör olarak değerlendirilebilir.

Objective: We aimed to investigate whether hemoglobin levels in COVID-19 patients can serve as a valuable predictor of mortality. Material and Method: This retrospective study included 156 COVID-19 cases who were admitted to the intensive care unit (ICU), demographic characteristics, clinical data, and laboratory findings were recorded. Results: There are no significant differences in mean age, gender ratio, comorbidities, symptoms, mean APACHE-2, and SOFA values upon admission observed between the anemic and normal groups. The normal hemoglobin (Hgb) group’s mean lymphocyte and lactate values were statistically high(p

Aim: Obesity is a known risk factor for cardiovascular diseases. However, there are also studies showing that increased body mass index is unexpectedly protective in myocardial infarction. More studies are needed to elucidate this situation, known as the obesity paradox. This study was conducted to investigate the relationship between waist circumference and mortality and morbidity in acute ST elevated myocardial infarct (STEMI). Material and Method: This is a prospective and observational study. Patients diagnosed with STEMI on electrocardiography (ECG) were included in the study. Immediately after the exhalation, waist circumference (WC) was measured on a horizontal plane at a point equidistant from the lowest floating rib and the upper border of the iliac crest. The role of waist circumference in the development of mortality and major cardiac events within 1 month was evaluated. Results: A total of 106 patients admitted to the emergency department with STEMI were included in the study. While increased waist circumference was associated with mortality, it was insignificant in terms of major adverse cardiovascular event (MACE) development. Low BMI is significant in terms of decreased mortality and MACE. Conclusions: The use of WC as an indicator of body fat ratio rather than weight in STEMI may be more valuable in the evaluation of mortality and MACE.

Purpose: The aim of this study is to investigate the power of disease severity scores to predict the development of Severe Acute Pancreatitis (SAP) and mortality in the early period over 65 years old diagnosed with acute pancreatitis in the emergency department. Materials and Methods: We calculated RANSON (on admission) and Computed Tomography Severity Index (CTSI) in addition to Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission to the emergency department. Results: One hundred and sixty patients (46.9% over 80 years of age) were included in the study. We observed statistically higher length of hospitalization, longer duration of stay in the intensive care unit, SAP and higher mortality in patients over 80 years of age. When we examined the ROC curve, we determined that the AUC values of the BISAP score were highest in both SAP and mortality estimation (AUC: 0.911, 95% CI 0.861-0.962; AUC: 0.918, 95% CI 0.864-0.9722, respectively). Binary logistic analysis indicated a 4.7-fold increased risk for SAP and a 12.3-fold increased mortality for each unit increase in BISAP score value. Conclusion: BISAP may be a good predictor for SAP and mortality estimation on admission to the emergency department in patients over 65 years of age with acute pancreatitis.

Purpose: There are not enough studies evaluating the change in electrolytes and hormones in patients with sepsis. The aim of our study is to evaluate the relationship between the changes in serum calcium (Ca), magnesium (Mg), phosphorus (P), 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) levels and mortality in patients with sepsis. Materials and Methods: Our study was conducted on patients with sepsis who were hospitalized in the intensive care unit (ICU) between October 2017 and January 2019. The levels of Ca, Mg, P, 25(OH)D and PTH, together with demographic and clinical characteristics of non-survivor and survivor patients, were compared. Results: A total of 225 patients were enrolled into the study. Of the 225 patients, 94 patients (41.2%) died and 131 patients (58.8%) were discharged. PTH and P levels were found to be significantly higher, and 25(OH)D, Ca, and Mg levels were significantly lower in non-survivor patients than in survivor patients. Conclusions: During sepsis, the change in Ca metabolism which is in a delicate balance, in the direction of hypocalcemia, hypomagnesemia, hyperphosphatemia, low 25(OH)D and high PTH were found to be associated with mortality.

Aim: This study aimed to examine the data of the coronavirus disease 2019 (COVID-19) patients treated with intravenous immunoglobulin (IVIG) treatment and to investigate the effects of the patients' clinical, laboratory, and treatment characteristics and risk factors for mortality. Material and Methods: The study evaluated 81 adult COVID-19 patients who were hospitalized for the treatment of COVID-19 between April 2020 and September 2020 and were followed up, treated, and consulted in the immunology clinic for IVIG treatment, in a retrospective manner. Results: The univariate analyses revealed that the duration of hospitalization in service, being intubated, duration of IVIG treatment, and the urea value before IVIG treatment were related to mortality in COVID-19 patients treated with IVIG treatment. As a result of multivariate analysis, being intubated and urea value before IVIG treatment were found to be independent risk factors for mortality (p=0.001 and p=0.009, respectively). It was found that for the 60 mg/dL level of urea value before IVIG treatment to predict mortality, the sensitivity was 46.2%, and the specificity was 35.5%. The area under the curve was found as 0.647; 95% confidence interval 0.518-0.776 (p=0.029). Conclusion: The study found that urea values before IVIG treatment were a risk factor for mortality in patients who received IVIG treatment for COVID-19. This is important as it indicates that urea values should be closely monitored in patients given IVIG treatment for COVID-19. It also suggests that when resources are limited and risk stratification is required in COVID-19 patients, urea values can be helpful.

Aim: The aim of this study was to examine the effects of antibiotic resistance, empirical antibiotic therapy, and comorbid diseases on 3-day and 28-day mortality in patients with bloodstream infections. Material and Methods: Files of the patients with positive blood cultures results, between January 1st, 2015, and January 1st, 2020 were analyzed retrospectively. The primary outcome was 3-day mortality and the secondary outcome was 28-day mortality. Results: A total of 515 patients, 208 (40.4%) female and 307 (59.6%) male, were included in the study. The median age of the patients was 73 (range, 18-95) years. Vancomycin resistance was detected in 8 (3.4%) of 233 gram-positive bacteria. Third-generation cephalosporin, meropenem, and colistin resistance rates of the 282 gram-negative bacteria were found to be 72.7% (n=205), 53.2% (n=150), and 9.9% (n=28), respectively. The 3-day and 28-day mortality rates were 14.4% (n=74) and 64.3% (n=331), respectively. Charlson comorbidity index score (CCIS) (p=0.001) and acute physiology and chronic health evaluation (APACHE) II score (p=0.019) were found to be risk factors for 3-day mortality. Risk factors for 28-day mortality were; age (p

Objective: Upper gastrointestinal system (UGIS) bleeding is a life-threatening abdominal emergency. Numerous scoring systems have been developed to identify patients who may develop mortality due to UGIS bleeding. We aimed to determine the effectiveness of the Glasgow Blatchford Score (GBS), Rockall score (RS), and AIMS 65 score in predicting the length of hospital stay, re-bleeding, and transfusion need. Material and Methods: It was carried out retrospectively by recording the parameters and clinical scoring systems collected from the archive files and epicrisis information of the patients with the pre-diagnosis of UGIS hemorrhage. Results: Sixty-three (67.7%) of 93 patients were male. Four patients (4.3%) needed intensive care, and in-hospital mortality occurred in 4 (4.3%) patients. Mortality was observed in 7 patients (7.5%), and recurrent UGIS bleeding was observed in six patients (6.5%). A statistically significant difference was found in AIMS 65 and Rockall scores in predicting -intensive care needs (p

We aimed to investigate the effects of the COVID-19 disease on kidney functions and early prognosis.

Aim: The aim of this study was to investigate whether preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have a predictive value in short-term mortality in patients with operable colorectal cancer (CRC). Material and Methods: A total of 231 (93 female, 138 male) patients with operated CRC between 2016 and 2021 in a university hospital were analyzed retrospectively. Median age was 68 (range, 26-92) years and patients had been under follow-up for a median of 25 (range, 0-54) months. Patients were grouped with respect to survival, those who were alive (n=175) and those who died (n=56) during the follow-up. Results: The area under the curve for NLR was 0.649 (95% CI: 0.563-0.734, p=0.001), optimal cut-off was 5.08 and demonstrated a sensitivity of 48.2% and a specificity of 81.7% for predicting mortality. The area under the curve for PLR was 0.635 (95% CI: 0.546-0.723, p=0.002), optimal cut-off was 221.5 and demonstrated a sensitivity of 55.4% and a specificity of 72.0%. Multiple regression analysis revealed that recurrence (OR: 60.910, 95% CI: 9.807-378.319, p=

Objective: The aim of the present study is to investigate whether the high sensitive troponin-I (HsTrop-I) and C-reactive protein (CRP) level that measured on admission is an independent predictor of mortality in patients with coronavirus disease 2019 (COVID-19). Materials and Methods: In this retrospective cohort study, a total of 175 consecutive patients with confirmed COVID-19 cases were screened from November 01, 2020 to January 31, 2021. Finally, 137 eligible patients were enrolled in to the study. Data of patients were recorded from the electronic medical records and National health data registry. Results: Mean age of study population was 49.7 ± 14.8 year and 88 (64.2%) patients were female. A HsTrop-I level ≥21.6 pg/ml measured on admission had a 86% sensitivity and 88% specificity in predicting mortality. The CRP level ≥80.8 mg/l on admission predicted mortality with 86% sensitivity and 95% specificity in patients with COVID-19. In the multivariate analyzes, HsTrop-I (odds ratio (OR) 1.124, 95% confidence interval (CI) 1.025–1.232; p=0.013) and CRP (OR 1.060, 95% CI 1.021–1.100; p=0.002) on admission were independent predictors of mortality in patients with COVID-19. Conclusion: HsTrop-I and CRP levels on admission which are easily measurable laboratory data were independent predictors of mortality in patients with COVID-19. Therefore, HsTrop-I and CRP levels could help to physicians for earlier triage of the patients that potentially worsening and may lead to provide the effective use of health resources.

Purpose: This study aimed to evaluate the patients who received health services in the pediatric intensive care unit (PICU) of Ankara City Hospital’s Pediatrics Department in a 2-year period and the outcomes of these cases by examining their clinical and demographic characteristics. Materials and Methods: This retrospective study was carried out in the 32-bed tertiary PICU of Ankara City Hospital. The records of 2280 patients between the ages of 1 month and 18 years who were hospitalized in the PICU between September 1, 2019, and September 1, 2021, were retrospectively analyzed. Age, sex, presence of chronic disease, reason for hospitalization in the intensive care unit, length of stay, status and duration of respiratory support, and mortality rates were evaluated. Results: The mean age of the patients was 5.16±5.12 years and the mean PICU stay was 12.47±20.16 days. Bronchiolitis, sepsis, pneumonia, trauma, congenital heart disease, status epilepticus, hematological diseases, oncological diseases, diabetic ketoacidosis, and metabolic diseases were found to be the most common reasons for hospitalization in the PICU. The most frequent underlying diseases were neurological, respiratory, hematological, cardiological, endocrinological, nephrological, gastrointestinal system, oncological, and metabolic diseases. The mortality rate of these patients was 10.8%. Underlying oncological or hematological diseases and immunodeficiency, higher susceptibility to infection, longer hospital stay, and longer duration of mechanical ventilation were found to be statistically significantly higher in deceased patients compared to survivors. Conclusion: The profile of patients admitted to PICUs is expanding day by day. A significant decrease in mortality was observed in all patient groups as a multidisciplinary approach was implemented. It was also observed that most of the patients had an underlying chronic disease and this condition was associated with mortality.

In emergency department, a delayed diagnosis and treatment of ileus causes a substantial increase in morbidity and mortality. : In this study we aimed to determine the major risk factors of mortality and hospital stay length in patients with ileus. It was determined that blood transfusion requirement; lactate, total bilirubin, and C-reactive protein levels; presence of colon cancer; and mean arterial pressure were among the parameters that can be used for predicting mortality in patients with ileus. In addition, qSOFA value and potassium, sodium, and total protein levels were determined to be among the parameters that are effective for determining the need for surgery in patients with ileus.

Introduction: Intracranial hemorrhages (ICH) are at high risk for long-term morbidity and morbidity in terms of complications such as epilepsy. In our study, we aimed to determine the effect of epileptic seizure seen after ICH on early mortality and to provide information to the literature. Methods: My study was done retrospectively. A total of 238 patients with a confirmed diagnosis of ICH who met the inclusion criteria were included in the study. In the classification of the seizure as early and late; early seizure up to the 14th day after bleeding; Seizures observed on the 14th day and above were classified as late seizures. Results: In the demographic data There was no significant difference between the groups in terms of age. Seizure + 57.7% of cases were male; seizure – 52.7% of the cases were male and the groups were not different in terms of gender. When the effect of seizure type on 30-day mortality was examined, it was observed that mortality was significantly higher in cases with late seizures. Conclusions: We determined that the epileptic seizure seen after ICH has an effect on mortality. Therefore, it is necessary to be careful in terms of mortality in cases with seizures. Especially in cases with late seizures, mortality is higher than in cases with early seizures, so it is necessary to be careful in terms of mortality in cases with late seizures. In addition, we found that the use of antiepileptic drugs did not affect mortality.

Purpose: In most countries, there is an ever-increasing admission rate of the elderly population into emergency departments (EDs). In particular, these elderly patients differ from younger patients because they have multiple comorbidities that affect the functionality and quality of life. The goal of this study is to reveal whether the Charlson comorbidity index (CCI) foresee the short- and long-term prognosis of the super-elderly patient population. Materials and Methods: The study was a descriptive, retrospective analysis of emergency department (ED) admissions by patients over 85 years of age and admitted to the Canakkale Onsekiz Mart University (COMU) Hospital between 2013 and 2018. The demographic data of the patients were analyzed according to CCI. Cox-regression analyses were conducted to determine whether the variables affected mortality. Results: A total of 1142 patients aged 85 and older (507 men, 635 women) with a mean age of 86.96±2.49 were included in the study. According to the multivariable Cox regression analysis male gender, CCI ≥6 and ICU admission were significantly associated with increased mortality rates Conclusion: The CCI predicts short and long-term prognosis in acutely ill, hospitalized super-elderly patients. The CCI could be used to select super-elderly patients at admission as an indicator of improvement at hospital discharge.

Contexte : Malgré les premiers rapports sur les déterminants sociaux de l’infection par le coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) et de la maladie à coronavirus 2019 (COVID-19), les analyses sur les inégalités attribuables à la COVID-19 au niveau national ont été limitées. L’objectif de cette étude est de décrire les inégalités en matière des décès attribuables à la COVID-19 au Canada en utilisant des données préliminaires obtenues dans le cadre de l’Initiative pancanadienne sur les inégalités en santé. Méthodes : Deux intégrations des données provisoires de la Base canadienne de données sur les décès de la Statistique de l’état civil ont été utilisées. Les données sur les décès survenus entre le 1er janvier et le 4 juillet 2020 parmi les résidents de logements privés ont été liées aux données, au niveau individuel, provenant du questionnaire abrégé du Recensement de 2016. Cette intégration a permis de ventiler les données de mortalité selon le sexe et la situation de faible revenu, le type de logement, le type de ménage et la taille du ménage. Les données sur les décès survenus entre le 1er janvier et le 31 août 2020 ont été liées aux données du Profil de Recensement au niveau local, du Recensement de 2016. Cette intégration de données a permis de ventiler des données de mortalité selon le sexe et les caractéristiques des quartiers, dont les ont été ventilées par sexe et par quintiles de composition ethnoculturelle (déterminés en fonction de la proportion de personnes ayant immigré récemment, appartenant à une minorité visible, étant nées à l’extérieur du Canada, ne connaissant ni l’anglais ni le français), par quintiles du revenu et par résidence dans une région métropolitaine. Les différences et les ratios des taux de mortalité liée à la COVID-19 normalisés selon l’âge (pour 100 000 habitants) entre groupes ont été estimés. Résultats : En juillet/août 2020, les résidents d’appartement, des grands centres urbains, des quartiers ayant la plus forte concentration de composition ethnoculturelle ou des quartiers ayant les plus faibles revenus ont connu 14 à 30 décès liés à la COVID-19 pour 100 000 habitants de plus comparativement aux groupes de référence (résidents d’une maison individuelle non attenante, ceux qui se trouvent en dehors des centres urbains, ceux résidant dans des quartiers avec la concentration de composition ethnoculturelle la plus faible ou ceux détenant les revenus les plus élevés, respectivement). Les inégalités entre les sexes étaient également plus importantes dans ces quatre groupes (11 à 18 décès chez les hommes de plus que chez les femmes pour 100 000 habitants) que dans les groupes de référence (2 à 4 décès chez les hommes de plus que chez les femmes pour 100 000 habitants). Conclusion : Ces résultats reflètent le fardeau global de mortalité plus élevé que subissent les populations défavorisées au niveau socioéconomique. Les domaines d’études futures sont abordés dans l’optique de guider une réponse à la pandémie axée sur l’équité en santé.

Amaç: Düzce ilindeki 2009-2020 tarihleri arasındaki PM10 ve PM2,5 kirliliğini incelemek ve AirQ programını kullanarak hava kirliliğine bağlı ölüm sayılarını belirlemek. Gereç ve Yöntemler: Tanımlayıcı tipteki bu ekolojik çalışmada 1 Ocak 2009 - 31 Aralık 2020 tarihleri arasındaki https://www.havaizleme.gov.tr/ (Erişim tarihi: 28.04.2021) adresinden elde edilen PM10 ve PM2,5 değerleri alınarak ortalama yıllık değerler hesaplanmış ve AirQ programında veriler kodlanarak önlenebilir ölüm sayıları hesaplanmıştır. Bulgular: Düzce’de 2009-2020 yılları arasında saatlik 105071 PM10 ölçümünden 99631 (%94.80)’i yapılmıştır. PM 2,5 yıllık ortalama değerleri 2018 yılında AB (Avrupa Birliği) sınır seviyesini 0,10 μg/m3 geçerken, diğer tüm yıllarda hem DSÖ’nün (Dünya Sağlık Örgütü) önerdiği (10 μg/m3), hem de AB’nin önerdiği yıllık 25 μg/m3 seviyesini ortalama 2-3 kat aşmıştır. Hava kirliliğine atfedilen ölüm nedeniyle hayatını kaybedenlerin sayısı 2009 yılında 722 kişi (%35,03), 2010’da 638 kişi (%33,69), 2011’de 727 kişi (%35,99), 2012’de 729 kişi (%34,49), 2013’de 625 kişi (%32,24), 2013’de 625 kişi (%32,24), 2014’de 801 kişi (%38,19), 2015’te 839 kişi (36,36), 2016’da 836 kişi (35,83), 2017’de 762 kişi (%33,08), 2018’de 501 kişi (%21,16), 2019’da 725 kişi (%30,29) ve 2020’de 706 kişi (%29,24)’dir. Sonuç: Düzce’de partikül madde kirliliği erken ölümlere neden olmaktadır. Hesaplanan yüksek hava kirliliğine bağlı ölüm oranlarının düşürülebilmesi için Düzce’nin hava kalitesinin iyileştirilmesi gerekmektedir.

Purpose: The aim of this study was to compare the efficacy of ISS (injury Severity Score), RTS (Revised Trauma Score) and ViEWS (VitalPAC Early Warning Score) scoring systems in predicting prognosis and mortality. Materials and Methods: Patients over the age of 18 who presented with multitrauma were prospectively examined between May 1, 2019 and November 1, 2019. Trauma scores, clinical outcomes within the first 24 hours, surgery requirement and 30-day mortality data were recorded. Results: The study included 435 patients, of whom 333 (76.6%) were male. The median age was 34 (IQR: 18-90) years. It was observed that ISS, RTS and ViEWS had a significant relationship with 30-day mortality. In the ROC analysis of 30-day mortality, no statistically significant difference was observed between the ISS, RTS, and ViEWS AUC values. There was also no statistically significant difference in terms of the ISS, RTS and ViEWS according to the length of hospital stay and surgery requirement. Conclusion: In addition to their relationship with mortality, it should be kept in mind that the investigated scoring systems may also be related to the length of hospital stay and surgery requirement.

Purpose: The aim of this study was to compare the reliability of scoring methods in determining critical geriatric patients in the emergency department. Materials and Methods: This prospective study included patients aged over 65 who presented to the emergency department between 15 October 2014 and 15 November 2014. APACHE II (Acute Physiology and Chronic Health Evaluation II), REMS (Rapid Emergency Medicine Score), HOTEL (Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence), VIEWS (Vital PAC Early Warning Score) and VIEWS-L (Vital PAC Early Warning Score with Lactate Level) were evaluated. Results: Of the 244 patients included in the study, the mean age of survivors was 75.69 ± 6.96 years, and the mean age of the mortal cases was 80.47 ± 6.63 years, 139 (57%) women. It was found that 30 (12.3%) of the patients included in the study died. The risk scores of the patients hospitalized in the intensive care unit were higher than those who were discharged or hospitalized. All risk scores in the mortality group were found to be significantly higher than the other patient groups. Conclusion: The study showed that risk scoring systems can be used safely in the evaluation of geriatric patients in the emergency department, to predict mortality and to select critically ill patients.

Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia. Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined. Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 ± 14.5 (23-90). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.73 times. Duration of hospitalization, requirement of intensive care and hospital mortality were similar in hypokalemia and normokalemia patients. Conclusion: In patients with Covid-19 pneumonia, hypokalemia has been found to be quite common as high as 16.8% at the first presentation. Hypokalemia was related to metabolic alkalosis but unrelated to the duration of hospitalization, requirement of intensive care including mechanical ventilation and hospital mortality.

Objective: This study aimed to investigate the role of platelet count, mean platelet volume (MPV), plateletcrit, platelet distribution width (PDW), platelet mass index (PMI), and MPV-to-platelet count ratio (MPR) in predicting short-term mortality in patients aged 65 and over with pulmonary embolism. Methods: This retrospective, observational, cohort study included corrected pulmonary embolism patients. Demographics, clinical characteristics, and platelet indices and the data of all-cause mortality within 30 days after admission were noted. The receiver operating characteristic curve analysis and multivariate analysis was performed to determine the discriminative ability of the scores. Results: A final analysis of 128 patients was performed. The mortality rate was 21.8%. There was no significant relationship in the multivariate analysis between mortality and platelet indices (Mann-Whitney U test). Area under curves of neutrophil-to-lymphocyte ratio, PMI, MPR, plateletcrit, platelet count, and MPV are 0.501, 0.640, 0.626, 0.642, 0.633, and 0.532, respectively. Conclusion As a conclusion based on results of our simple, platelet indices could not predict short-term mortality in elderly patients with pulmonary embolism.

Affichée comme une priorité de la gestion du risque d’inondation, la sécurité des populations est rarement évaluée dans les bilans des catastrophes naturelles en France. Plus que les bilans humains, ce sont les dommages socio-économiques qui sont mis en avant comme indicateurs de la prévention. Cet article présente un recueil de données sur les décès liés aux inondations dans le sud de la France (BD Vict-In). 328 victimes ont étérecensées entre 1980 et 2020. L’article présente le profil des personnes décédées et une analyse des circonstances et des lieux de décès. Il ressort que les victimes sont majoritairement des hommes (61%) de la classe d’âge 40-70 ans. 35% des décès sont liés à l’automobile et 31 % ont lieu au domicile. Parmi les comportements dangereux, le franchissement de cours d’eau en véhicule ou à pied (50 cas recensés) ou les refus d’évacuation (24 cas) sont les plus représentés. 29 décès ont eu lieu dans des campings. La cartographie du taux de mortalité montre la forte exposition des arrière-pays méditerranéens qui associent fréquence des épisodes pluvieux, fortes pentes et urbanisation croissante. L’évolution temporelle montre une diminution du nombre de décès par événement mais une augmentation du nombre d’inondations meurtrières.

Objective: The ‘top of the basilar syndrome’ (TOBS) may occur when an embolus impacts in the distal basilar artery. We aimed to investigate the relationship between the clinical, radiological parameters of TOBS, its prognosis, and mortality rates, in Xxxxxxx, Turkey. Materials and Methods: Age, sex, presenting symptoms, National Institutes of Health Stroke Scores (NIHSS), infratentorial infarct volume (IIV), supratentorial infarct volume (SIV) lenght of stay (LOS) in neurology clinic and intensive care unit (ICU), the duration of mechanical ventilation (MV) and mortality were recorded. Results: Thirty-one patients (18 female,13 male) with diagnosed TOBS were included. The frequency was 2.2% among 1379 patients within 2,5years. The mean age was 69.0±12.1years. According to NIHSS, 11 (35.5%) patients had mild stroke, 16 (51.6%) moderate, and 4 (12.9%) severe stroke. The mean IIV was 8.84±10.44mm3 (0.17-33.88), SIV was 15.11±22.32mm3 (0.11-87.91). The average LOS in neurology clinic was 6.0±3.6, in ICU was 40.8±40.3days. Twenty-one (67.7%) patients needed to be in an ICU. Patients admitted to the ICU had significantly higher decreased level of consciousness (DLC) and visual abnormalities, NIHSS, IIV.(p0.05) 13/21 patients admitted to the ICU required MV. The mean duration of MV was 33.8±45.3days. DLC, ataxia, visual abnormalities as an initial symptoms, NIHSS, IIV were higher among patients who required MV compared with who did not. The mortality rate was 32.3%. NIHSS, LOS in clinic and ICU, the duration of MV of patients who died were statistically higher.(p0.05) Conclusions: It is important to determine effective parameters in order to prognose TOBS which is a rare stroke syndrome.

Abstract Background : Acute mesenteric ischemia (AMI) is a life-threatening pathology that often requires urgent surgical intervention. It is frequently faced in elderly patients. Despite advances in the diagnosis of AMI morbidity, and mortality rates are still high. The presence of comorbidities delayed surgical intervention due to diagnostic difficulties, and in most cases, older patients with heart problems may be remarkable factors for higher mortality rates. Diagnostic challenges are tried to be overcome with both imaging methods and laboratory findings. Unfortunately, to date, no clear laboratory parameters have been described in diagnosing or predicting mortality of mesenteric ischemia. Materials and Methods : The patients diagnosed with acute arterial mesenteric ischemia between the dates 2010-2019 were enrolled in the study. Demographic characteristics, diagnostic biochemical parameters (lymphocyte, neutrophil, albumin, C-reactive protein, lactate, lactate dehydrogenase, Di-Dimer, troponin, white blood count, platelet, fibrinogen, creatine kinase-MB) levels, as well as comorbidities of the patients, were evaluated. Results : A total of 149 patients was enrolled in the study, with a mean age of 66.11 . In the non-survivor group, neutrophil, RDW, lactate, DDM, Fibrinogen, and CK-MB levels, furthermore albumin levels were defined as significantly elevated in the survivor group (p0.05). Hypertension was the major comorbidity by far in both groups. Conclusion : High levels of fibrinogen, lactate, DDM, CK-MB levels and low levels of albumin levels may be predictors of mortality in mesenteric ischemia.

Objective: This study aimed to evaluate the clinical presentations, outcomes, and changes over 8 years period of infective endocarditis (IE) patients in a tertiary hospital in Turkey and to identify predictors of mortality. Materials and Methods: All adult patients who were hospitalized with a diagnosis of definite IE were included in the study. The data were analyzed both collectively and separately in two consecutive four-year periods i.e. 2010-2013 and 2014-2017. Results: There were 72 IE cases in the study. Male/female ratio was 1.57:1 (44 males,28 females). The mean age of the patients was 48.5±17.6 years. Staphylococci were the most common agents (44%). Independent predictors of mortality were heart failure, the invasive procedure before IE, and lower platelet level. Increased invasive procedures before IE and enterococcal endocarditis were found significantly to be higher during the last period (2014-2017). Conclusions: IE is still a serious and deadly disease in the 21st century. Our data indicate that invasive procedures have been increasing before IE and this increase with associated poor prognosis.

Purpose: The aim of this study was to evaluate the general clinical characteristics of acute gastrointestinal system (GIS) bleeding patients who were followed-up in the intensive care unit (ICU) and the risk factors for mortality. Materials and Methods: The GIS bleeding patients followed up in a medical ICU between October 2016 and March 2019 were included. Patients were evaluated for demographic, clinical and laboratory data (on admission and after 24-hours) and compared according to the mortality status (surviving vs. non-surviving). Results: A total of 64 patients (37 males and 27 females) with a median age of 73.5 (31-93) years were evaluated. All patients had upper GIS bleeding and the mortality rate was 29.7%. There was no difference between the mortality groups for gender, age and chronic co-morbid diseases except malignancy. High BUN, creatinine, INR, and lactate levels after 24 hours were significantly associated with mortality. All patients had a diagnosis of upper GIS bleeding. In the logistic regression analysis, the presence of acute respiratory insufficiency, long hospital stays before ICU, high SOFA score and high lactate levels after 24 hours were the independent predictors of ICU mortality). Conclusion: In this study, we found that high levels of BUN, creatinine, INR, and lactate levels in the first 24 hours of follow-up, rather than the values on admission to ICU, were associated with increased mortality. Therefore, we suggest that close monitoring and rapid normalization of these values with appropriate treatments is important.

Amaç: Sars-Corona Virüsü (SARS-CoV-2), 2019 yılının aralık ayında ilk kez Çin’de görülen ve şiddetli akut solunum yetmezliğine neden olan bir korona virüstür. Diyabet tüm dünyada morbidite ve mortalitenin önemli sebeplerinden biri olmakla beraber diyabetik hastalarda koronavirüs enfeksiyonun morbidite ve mortalitenin daha yüksek olduğu saptanmaktadır. Biz bu çalışmamızda İç hastalıkları kliniğinde koronovirüs enfeksiyonu ve koronavirüs enfeksiyonu şüphesi ile takip edilen diyabetik hastalarda Hba1c, kan şekeri profilinin morbidite ve mortalite üzerine etkisinin retrospektif olarak analizinin yapılmasını amaçladık. Gereç ve Yöntem: İç hastalıkları kliniğinde 15/03/20 ile 01/07/20 tarihleri arasında SARS-CoV-2 enfeksiyonu nedeniyle takip edilen diyabetik hastalar çalışmaya dahil edildi. Hasta dosyaları taranarak anamnez, labaratuvar, tedavi ve prognoz oluşturulan formalra kaydedildi. Diyabetik hastalardaki koronavirüs enfeksiyonlarında hastanın Hba1c, kan şekeri profili ve lipid profilinin yoğun bakım ihtiyacı için risk faktörü olarak kullanılmasının ek bir fayda getirip getirmediği istatistiksel yöntemlerle analiz edildi. Bulgular: Hastanemiz dahiliye kliniğinde Covid-19 enfeksiyonu nedeniyle yatan daha önce diyabet tanısı alan oral antidiyabetik ve/veya insulin kullanan toplam 31 hasta retrospektif olarak incelenmiş olup hastaların demografik özellikleri Tablo-1 de belirtilmiştir. 31 hastanın tamamı boğaz ağrısı, öksürük, ateş ve nefes darlığı gibi tipik bulgular ile hastaneye başvurdu. Hastaların tamamına BT çekildi ve nasofarnegeal ve orofarengeal PCR alındı. PCR testi pozitif saptanan 18 hasta (%58.1) ve Tipik BT tutulumu olan 30 hasta (%96.8) saptandı. Covid-19 nedenli takip edilen diyabeti olan 31 hastanın 17 sinde; hipoksi, takipne ve hipotansiyon gibi sebepler ile yoğun bakım ihtiyacı gelişti. Yoğun bakım ihtiyacı olan 17 hastanın 10’u mortal seyretti. Açlık kan şekeri yüksekliği ile yoğun bakım ihtiyacı ve mortalite arasında anlamlı ilişki saptandı. HbA1C ve lipit profili ile yoğun bakım ihtiyacı arasında anlamlı ilşki yoktu. Mortal grupta LDL ve total kolesterol anlamlı düzeyde düşük tespit edildi. Sonuç: Diyabetik hasta grubunda kötü glisemik kontrol ve lipit parametreleri prognostik faktör olarak dikkate alınmalıdır.

Purpose: In the present study, the possibility of predicting mortality with the change in coagulation parameters depending on the severity of Covid-19-associated pneumonia was investigated. Materials and Methods: A total of 137 patients with Covid-19-associated pneumonia were included in the study. The patients were divided into three groups according to the severity of pneumonia as mild, moderate and severe. According to the severity of pneumonia, the parameters of complete blood count and the levels of biochemical parameters were compared between the groups. By examining blood parameters according to mortality, ROC analysis and regression analysis were performed to determine the net effect of these parameters on mortality. Results: As the severity of pneumonia increased, Prothrombin time (PT), International normalized ratio (INR) and Activated partial thromboplastin time (aPTT) values were also increased, and a statistically significant difference was found between the groups in PT and INR values. PT, INR and aPTT levels were higher in cases with mortality. Mortality can be predicted with 93.5% sensitivity and 97.5% specificity. according to the >45.1 seconds(sec) cut-off value of the coagulation parameter (aPTT+PT. Conclusion: The coagulation parameter (aPTT + PT), whose level increases secondarily to the increase in Covid-19-associated pneumonia severity, provides successful results in predicting mortality, and may be a parameter that we can recommend in clinical use.

Purpose: The aim of our study is to investigate the prognostic value of Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in determining mortality in patients hospitalized for intensive care unit (ICU) sepsis. Materials and Methods: This study retrospectively evaluates all patients hospitalized with sepsis in our ICU between February 2017 and April 2018. In addition to the demographic and clinical characteristics of the patients, complete blood count parameters were also recorded. Demographic and clinical characteristics, mainly NLR, MLR and PLR results, and other laboratory results of patients with sepsis were compared between the ones with and without mortality. Results: Four hundred and eleven patients were included in the study. 55.7% (229/411) of patients with sepsis died and 44.3% (182/411) were discharged alive. NLR, MLR and PLR were higher in the group with mortality compared to the survivor group. The cut-off value for predicting mortality in patients with sepsis was 9.2 for NLR, ≥0.8 for MLR, and ≥187.3 for PLR. The area under the curve (AUC) value for NLR was 0.825, the AUC value for MLR 0.835 and the AUC value for PLR was 0.720. Conclusion: High NLR, MLR and PLR values are associated with mortality in sepsis patients hospitalized in ICU, and the most significant parameter for mortality indicator among the three rates was found to be MLR with the highest AUC value.

Background: Despite significant advances in the treatment of heart failure, the prognosis of acute cardiogenic pulmonary edema (ACPE) continues to be a serious problem. The objective of this study is to determine the risk factors affecting in-hospital mortality in patients with ACPE. Methods: We enrolled 305 patients who were hospitalized with cardiogenic pulmonary edema as a diagnosis. Clinical, biochemical and echocardiographic variables were collected and analysed. The patients were divided into two groups according to the presence of mortality. Both groups were evaluated in terms of clinical features during admission to the emergency department (ED) and factors affecting in-hospital mortality. Results: Forty-two patients died and the mortality rate was 13.8%. To determine the factors affecting mortality, multiple logistic regression analysis was performed. In the regression analysis, it was seen that age at admission to the ED (OR:1.75, 95% CI 1.18-3.05, p:0.014), systolic blood pressure (OR:0.95, 95% CI 0.31-0.98, p:0.040), presence of acute myocardial infarction (OR:4.17, 95% CI 1.85-7.13, p:0.001), positive troponin (OR:5.47, 95% Cl 1.07-7.46, p:0.011), atrial fibrillation rhythm (OR;3.16, 95% CI 1.81-8.02, p:0.010), inotropic drug usage (OR;5.61, 95% CI 1.87-9.24, p:0.013) increased in-hospital mortality. Conclusion: Our findings could help clinicians in identifying patients with poor prognosis early in the presence of identified risk factors.

Amaç: Çocuk Yoğun Bakım Ünitesinde ÇYBÜ kalp hastalığı nedeni ile takip edilen hastaların klinik özellikleri ve mortalite üzerine etki eden faktörlerin belirlenmesi amaçlandı.Gereç ve Yöntem: Ocak 2009-Aralık 2011 tarihleri arasında yatırılarak izlenen konjenital ve akkiz kalp hastalığı tanısı konan hastalar incelendi. Hastaların tanıları, klinik özellikleri ve mortalite üzerine etki eden faktörler araştırıldı.Bulgular: Çalışmada kalp hastalığı tanısı ile yatırılarak izlenmiş 65 olgunun verileri değerlendirildi. Hastaların büyük çoğunluğu VSD gibi asiyanotik hastalardı ve bunlar genellikle enfektif endokardit EE tanısı ile izlendi. Büyük çoğunluğunda konjestif kalp yetmezliği KKY , pulmoner hipertansiyon PHT ve büyüme geriliği mevcuttu. Atriyoventriküler septal defekt AVSD tanılı hastalar pnömoni, akut konjestif kalp yetmezliği KKY ve pulmoner hipertansiyon krizi nedeniyle yatırılmış Down sendromlu vakalardan oluşmaktaydı. Siyanotik hasta grubu ise fallot tetralojisi TOF , büyük arter transpozisyonu BAT , trikuspit kapak atrezisi TA , hipoplastik sol kalp sendromu ve geniş VSD gibi tek ventrikül yapısına sahip hastalıklardan oluşmaktaydı. Miyokardit vakalarının büyük bir çoğunluğu viral miyokardite bağlandı. Kardiyomiyopatili KMP 14 olgu incelendi ve Naxos hastalığı olan 2 olgu ile non-compaction’lu 1 olgu kaybedildi. Aritmi nedeniyle 5 SVT’li, 2 Long QTc sendromlu olgu izlendi. Hastaların % 20’de kalp hastalığı dışında başta Down sendromu olmak üzere ek hastalıklar vardı. Sonuç: Yoğun bakım ünitesinde takip edilen hastalarda Atriyoventriküler septal defekt AVSD , dilate kardiyomiyopati DKMP ciddiyeti, mekanik ventilatöre bağlanma durumlarının ve inotrop kullanımının mortalite için risk faktörü olduğu saptandı

Objective: Ischemic heart disease remains the leading cause of death. Not only strategies of health care providers but also population characteristics are also important to extend life expectancy in patients with cardiovascular disease. Thus clinical studies including national cohort of patients provide important insights into the real-life health care. We aimed to assess intra-hospital and long-term outcomes in patients with ST-elevation myocardial infarction (STEMI). Materials and Methods: A total of 178 STEMI patients treated with primary percutaneous coronary intervention (PCI), who were documented to be death or responded the telephone interview, were included into the analyses. These patients were divided into three groups according to age (Group-1: