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Background: To describe the state of health, through healthcare consumption and mortality, of people admitted to nursing homes (Ehpad) in France., Methods: People over the age of 65 years admitted to an Ehpad institution during the first quarter of 2013, beneficiaries of the national health insurance general scheme (69% of the population of this age), were identified from the Resid-Ehpad database and their reimbursed health care was extracted from the SNIIRAM database, identifying 56 disease groups by means of algorithms (long-term disease diagnoses and hospitalisations, medicinal products, specific procedures). Disease prevalences were compared to those of other beneficiaries by age- and sex-standardized morbidity/mortality ratios (SMR)., Results: A total of 25,534 people were admitted (mean age: 86 years, 71% women). Before admission, these people presented a marker for cardiovascular or neurovascular disease (48% of cases), dementia (34%), cancer (18%), and psychiatric disorders (14%). Compared to non-residents, new residents more frequently presented dementia (SMR=3-40 according to age and sex), psychiatric disorders (SMR=2.5-12, including psychotic disorders SMR=18-21 in the 65-74 year age-group), neurological disorders (SMR=2-12, including epilepsy SMR=14 in the 65-74 year age-group), and cardiovascular and neurovascular disease (SMR=1.2-3). Overall mortality in 2013 was 22%, with a maximum excess between the ages of 65-74 years (males, SMR=8.8, females, SMR=15.9)., Conclusion: Medical and administrative data derived from linking the Resid-Ehpad/Sniiram databases reveal a severely impaired state of health, considering healthcare use of institutionalized dependent elderly people, and a high prevalence of diseases responsible for severe dependence and excess mortality, especially among the younger residents., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Aim: This study aims to analyze the experience of a tertiary health center about the complications of hysterectomy within a period of five years. Materials and Methods: This is a retrospective review of 1311 hysterectomies which were performed for both benign and malignant indications between 1 January 2017 and 1 January 2023. Results: Complications occurred in 218 patients (16.6%) and the mortality rate was 0.5% (n=6). The rate of conversion into laparotomy was 2.8%. Bladder injury, colon injury, ileus and incisional hernia were significantly more frequent in women who underwent laparotomy (p=0.007, p=0.026, p=0.027 and p=0.010 respectively). Logistic regression analysis indicated hysterectomy technique as an independent prognostic factor for its complications (p=0.001). Ureter injury, bladder injury and colon injury were significantly less frequent in patients who had hysterectomy for gynecological malignancy (p=0.001, p=0.001 and p=0.015 respectively). Hospital stay was significantly longer in patients undergoing hysterectomy for laparotomy and gynecological malignancy (p=0.001 for both). Conclusion: Minimally invasive techniques such as laparoscopy or vaginal approach should be attempted whenever it is possible and feasible. Performing hysterectomy for benign pathologies should not be considered as a distraction from meticulous work during the preoperative preparation and postoperative monitorization periods. Similar attention should be also paid to patients who have chronic diseases. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Trois études prospectives randomisées ont démontré l'efficacité de l'autogreffe de cellules souches hématopoïétiques (CSH) dans la sclérodermie systémique (ScS) sur la survie. Ces résultats incitent à proposer cette thérapeutique à des patients qui ont maladie rapidement évolutive et qui ont des symptômes précoces mais pas d'atteinte viscérale évoluée. L'autogreffe de CSH peut ainsi être discutée chez les patients atteints de ScS cutanée diffuse avec une durée de la maladie depuis les premières manifestations viscérales (cutanées, cardiaques, digestives, pulmonaires, ou rénales) hors phénomène de Raynaud de moins de 5 ans. Pour autant, les indications de l'autogreffe de CSH dans la ScS validées à l'échelon Européen et dans le protocole national de diagnostic et de soins (PNDS) sont plus larges et certaines de ces indications sont discutables, en particulier chez les patients ayant une pneumopathie interstitielle diffuse aggravative. Ces indications sont discutées de façon argumentée, en prenant en compte le niveau de preuve et la toxicité de l'autogreffe de CSH. Three prospective randomized studies have demonstrated the efficacy of autologous hematopoietic stem cell (HSC) transplantation in systemic sclerosis (SSc) on survival. These results encourage us to offer this therapy to patients who have a rapidly progressive disease and who have early symptoms but no advanced visceral involvement. HSC autograft can thus be discussed in patients with diffuse cutaneous SSc with a duration of the disease since the first visceral manifestations (cutaneous, cardiac, digestive, pulmonary, or renal) excluding Raynaud's phenomenon of less than 5 years. However, the indications for HSC autograft in SSc validated at European level and in the national diagnostic and care protocol (PNDS) are broader and some of these indications are debatable, in particular in patients with worsening diffuse interstitial lung disease. These indications are discussed in a reasoned way, taking into account the level of evidence and the toxicity of the HSC autograft. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Ankara Training & Research Hospital is the property of Medical Journal of Ankara Training & Research Hospital and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Although surgical treatment of hip fracture provides favourable outcomes, comorbidities and preoperative optimization determine the recovery and rehabilitation period in elderly population. This study evaluated the role of anesthesiologic management for appropriate timing of surgery, and other patient-specific factors for surgical intervention. Methods: The study group comprised of 240 geriatric patients with acute hip fractures, who underwent surgery at an academic tertiary care unit. Preoperative, intraoperative and postoperative variables associated with anesthesiologic management were retrospectively evaluated. A 30-day mortality and morbidity were the primary and secondary outcomes. Results: The median time between the patient’s admission to the hospital and the time of surgery was 1 day. Approximately 29% patients stayed in intensive care unit postoperatively. The median length of hospitalization was 5 days, while the 30-day mortality rate was 1.3%. The American Society of Anesthesiologists (ASA) physical status was identified as the most common factor that significantly affected the 30-day mortality. Conclusion: To date, no consensus has been reached on the appropriate delay period for surgery of acute hip fractures. Our study demonstrates that the main factors determining the patient prognosis are ASA physical status score, and the functional status of the patients. Therefore, perioperative anesthesiologic management should be prioritized to provide optimization of these patients. [ABSTRACT FROM AUTHOR]

Objective: Spontaneous subarachnoid hemorrhage (sSAH) is a significant disease requiring urgent intervention. It may develop because of the rupturing of intracranial aneurysms and has high mortality and morbidity rates. This study was conducted at a hospital that serves as a reference center in the region in which it is located with the aim of evaluating patient characteristics, patient preferences, and complication management among patients with aneurysmal subarachnoid hemorrhage (aSAH) and presenting the results of these intracranial aneurysm clipping surgeries. Methods: Cases of 261 patients who were admitted with a diagnosis of sSAH were retrospectively examined. Subsequently, 107 patients with aSAH who were treated with 117 microsurgical aneurysm clippings were included in the study. The effects of patient demographics, Glasgow coma scale (GCS) scores, clinical World Federation of Neurological Surgeons scale and Hunt/Hess scale scores, and radiological modified Fisher scale gradings on modified Rankin scale (mRS) scores were examined. The management of complications such as rebleeding, cerebral vasospasm (CV), and delayed cerebral ischemia and surgical results were compared according to clinical and radiological data. Results: Of the patients, 52 were female (48%) and 55 were male (52%). Their average age was 50.4 years (range: 29-78 years), and the mean follow-up period was 13.8 months or 414 days (range: 30-892 days). The most common complaint of the patients at admission was headache (75.8%). Approximately 72.9% of patients had GCS scores of 14 or 15 at first admission. Twenty-eight (26.1%) patients had multiple aneurysms. Thirteen (12%) patients required a permanent cerebrospinal fluid drainage system. Rebleeding occurred in 7 (6.5%) patients before treatment. Thirty-six (33.6%) patients had a clinical CV. Delayed cerebral ischemia occurred in 25 (23.3%) patients. At the end of the mean follow-up period of 13.8 months, 82.3% of the patients had slight or no disabilities (mRS: 0-2), whereas 11.2% had severe disabilities (mRS: 3-5). Seven (6.5%) patients died, thus having an mRS score of 6 (exitus). Five (4.6%) patients had residual aneurysms. Six (5.6%) patients had parent or perforating artery occlusion. Conclusion: Poor prognosis at admission, rebleeding, and CV complications remain the most important causes of mortality and morbidity related to aSAH. Evaluations of the diagnoses, treatments, and complication management of patients with sSAH and the multidisciplinary approaches of experienced endovascular and neurosurgical teams are important for better understanding and management of this disease. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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

Objective: Cholangiocarcinomas (CC) are rare tumors that develop from the biliary tract and surgery is the gold standard for them. All efforts have been made by surgeons from past to present to obtain R0 resection. The aim of the study was to examine the surgical therapy of CCs, which we have applied various surgical treatments in our clinic in the last three years. Methods: Patients whose pathological examination yielded Hiler CC and underwent surgical operation at our clinic between February 2019 and February 2022 were retrospectively evaluated. Results: Twenty five patients were found suitable for the study. Nine were male and 16 were female, with a mean age of 61.72±11.12 (minimummaximum: 29-76) years. The overall morbidity rate in the postoperative period was 52%, and liver failure in the postoperative period was seen in 4 patients. Bile leakage developed in 2 patients. Portal vein thrombosis was detected in 2 patients and surgical site infection was detected in 5 patients. No mortality was seen in the intraoperative and postoperative periods. In the follow-up period, recurrence was observed in 3 patients and mortality was observed in 3 patients. Conclusion: Advanced surgical techniques have induced extended indications in surgery and reduced mortality and morbidity ratios, and oncologic outcomes were more acceptable than before. The most significant purpose is to perform R0 resection to maintain adequate remnant liver volume. Such complex surgeries require multidisciplinary treatment in specialized hepatopancreaticobiliary and liver transplant services to optimize surgical and oncological outcomes. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the results of incarcerated anterior abdominal wall hernia cases in which we performed emergency surgery in light of the literature. Materials and Methods: The records of 124 patients who underwent emergency surgery for incarcerated anterior abdominal wall hernia between January 2016 and December 2019 were retrospectively reviewed. The patients' files, computer records, epicrisis reports, surgery reports, and outpatient clinic records were evaluated. Patients; Age, gender, hernia type, location, time of admission, previous hernia surgery history, affected organs, type of anesthesia applied, surgical techniques, resection status, length of hospital stay, morbidity, and mortality rates were recorded. Results: The mean age of 124 patients was 59.47 ± 17.75 (17-94) years. Of the patients, 64 (51.6%) were female, and 60 (48.4%) were male. The mean hospital stay was 4.12±3.52 (1-19) days. Thirteen (10.5%) patients had additional disease. General anesthesia was applied to 100 (80.6%) patients, and regional anesthesia was applied to 24 (19.4%) patients. 25 patients were operated on with the diagnosis of recurrence and 99 with the diagnosis of a primary hernia. The most frequently compressed organs in the hernia sac were the omentum (64.5%) and small intestine (32.2%). Bowel resection was performed in 16 of the patients. Mesh was applied to 90 patients during the operation. The most common hernia types were inguinal, umbilical, and incisional. 31 (13.7%) complications developed in 17 patients. Sepsis, wound infection, ileus, atelectasis, and respiratory failure were the most common. Mortality was developed in 6 (4.8%) of the patients. Conclusions: This study showed that additional disease increases morbidity in hernia cases, and intestinal resection due to strangulation increases morbidity and mortality. Therefore, patients presenting with an incarcerated hernia should be operated on as soon as possible before strangulation develops. [ABSTRACT FROM AUTHOR]

Objective: Late preterm infants are immature regarding respiratory, metabolic, neurological, and immunological features and have a high risk for morbidity and mortality. Therefore, it is aimed to draw attention to the problems that may develop in newborn care by scanning all hospitalization and mortality rates of late preterm infants. Method: In this retrospective study, late preterm infants hospitalized in a tertiary university hospital between January 1, 2007, and December 31, 2014, having the study admission criteria, were enrolled. Results: A total of 1,088 late preterm infants were included in the eight-year study period. According to their gestational weeks, the infants were divided into three main groups; 31.4% (n=342) were in group 1 (340/7-346/7), 30.6% (n=333) were in group 2 (350/7-356/7), 38% (n=413) were in group 3 (360/7-366/7). The most common causes for admission to the neonatal intensive care unit were hyperbilirubinemia, suspected sepsis and infections, respiratory morbidities, poor feeding, and hypoglycemia; reasons for rehospitalization included jaundice, infections, suspicion of sepsis, and poor feeding. In addition, neonatal transient tachypnea, apnea, hypoglycemia, early-onset sepsis, healthcare-associated infection were most common in those born at 34-346/7 gestational weeks; respiratory distress syndrome, pneumonia, late-onset sepsis were most frequently in those born at 35- 356/7 gestational weeks. Conclusion: As a result, late preterm infants are at risk for respiratory disorders, sepsis, jaundice, and metabolic problems; the need for intervention increases as gestational age decreases. The delivery timing should be planned with these problems in mind, and the follow-up and treatment of late preterm infants should be carried out accordingly. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We aimed to comparison of serum albumin and lactate level for predicting neonatal morbidities and mortality in preterm infants < 32 weeks of gestation. Materials and Methods: The medical records of babies were retrospectively analyzed. Patients were divided into three groups; plasma albumin levels ≤ 2.5 g/dL were defined as Group 1, 2.6-3 g/dL as Group 2 and ≥ 3 g/dL as Group 3. The babies < 28 weeks of gestation were analysed as a subgroup. Results: 300 infants with mean gestational age of 28.7 ± 2.4 weeks and mean birth weights 1240 ± 405 grams were included. In predicting mortality; the sensitivity of the albumin level within the first three days was 74.4% and the specificity was 73.2% (cut-off < 2.9 g/dL), the sensitivity of the lowest albumin level was 90.7% and the specificity was 70.1% (cut-off < 2.65 g/dL), the sensitivity of the lactate level was 67.4% and the specificity was 63.3% (cut off > 3.1 mmol/L). Analysis of < 28 weeks babies; the sensitivity of lowest albumin level was 80% and the specifity was 66.7% (cut-off < 2.45 g/dL) and the sensitivity of the albumin level within the first three days was 74.3% and the specificity was 72.6% (cut-off < 2.8 g/dL), and the sensitivity of lactate was 74.3% and the specifity was 64.2% (cut-off > 3.1mmol/L). Conclusion: Low serum albumin level appears to be more specific and sensitive than lactate in predicting mortality and may be considered to be added to mortality prediction scores. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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<0.001). There was a significant difference between the groups in terms of the postoperative complications rate and it was more common in the anemic group (p<0.001). There was a significant difference between the groups in terms of the need for intensive care and blood transfusion in the postoperative period (p=0.020, p<0.001, respectively). Conclusion: Preoperative anemia increases postoperative complications in hiatal hernia surgery. Therefore, the presence of anemia should be investigated before hiatal hernia surgery and patients with anemia should be followed up closely postoperatively. [ABSTRACT FROM AUTHOR]

Copyright of Mersin Üniversitesi sağlık Bilimleri Dergisi is the property of Mersin University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Indigenous Peoples are much more likely than non-Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future research ought to incorporate social--environmental factors. Methods: We conducted a systematic review and meta-analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social--environmental--economic factors (e.g. prevalent low socioeconomic status). Results: Eleven comparative cohorts that resulted in 23 at minimum, age-standardised, mortality or morbidity rate outcomes were included in our meta-analysis. Indigenous Peoples were twice as likely as non-Indigenous Peoples to be seriously injured (rate ratio [RRpooled] = 2.18) and more than 3 times as likely to die (RRpooled = 3.40) in MVCs. Such great risks to Indigenous Peoples do not seem to have diminished over the past generation. Furthermore, such risks were greater on-reserves and in smaller, rural and remote, places. Conclusion: Such places may lack community resources, including fewer transportation and healthcare infrastructural investments, resulting in poorer road conditions in Indigenous communities and longer delays to trauma care. This seems to add further evidence of geo-structural violence (geographical and institutional violence) perpetrated against Indigenous Peoples in yet more structures (i.e. institutions) of Canadian society. Canada's system of highways and road-ways and its remote health-care system represent legitimate policy targets in aiming to solve this public health problem. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Endovascular aortic repair (EVAR) has been preferred increasingly surgical repair for abdominal aortic aneurysms (AAAs). This minimally invasive procedure has favorable effects in the early period but our purpose is to reveal the anatomical and non-anatomical risk factors affecting mortality and morbidity after EVAR in the prolonged period.Materials and Methods: A total of 96 patients ( 91m, 5 f) electively EVAR operated for infrarenal AAAs between September 2014 to January 2019 is included to the study. Preoperative and postoperative computed tomography (CT) scans is controlled periodly and determined individually. Demographic factors, anatomical properties of the AAAs and non-anatomical risk factors are assessed. Kaplan-Meier survival analysis was used to determine survival rates. Cox regression and hazard ratio (HR) was used to assess the relation of these determined factors on mortality and morbidity.Results: Mean follow up time was 27,45 ± 12,99 months. We found that aortic neck morphology has an statistically significant effect on mortality (p value: 0.046 and HR: 1,73 [ 1,01-2,96]). Aortic neck angle, cigarette smoking, obesity, Peripheral artery disease(PAD), coronary artery disease, chronic obstructive pulmonary disease have an increased hazard ratio on mortality ( HR in order; 1,39; 1,45; 3,33; 1,84; 1,87; 3,60). Increased creatinine level (p value: 0.003), precence of chronic renal failure (p value: 0.013)and diabetes mellitus (p value: 0.038) have an statistically significant negative effect on morbidity. Obesity and PAD have an increased hazard ratio on morbidity(HR in order; 4,58; 1,61). Conclusion: This study showed us survival after EVAR procedure is connected with several pre and postoperative factors. Preoperative datailed evaluation for the anatomical properties of aneurysm is important to achieve prolonged benefit and postoperative follow up is crucial.

Objective: Laboratory parameters may predict the severity and mortality of coronavirus disease-2019 (COVID-19). We investigated the relationship of laboratory findings obtained at admission and 72nd hour and mortality and morbidity of patients with pneumonia who were treated in two intensive care units. Materials and Methods: Chart data of 75 patients (March-May 2020) were retrospectively analysed. Patient characteristics and laboratory parameters were compared according to the presence of COVID-19 and mortality. Patients with COVID-19 were compared according to mortality and gender. Results: The mean patient age was 74.7±11.3 years. COVID-19 positivity was not associated with marked differences in laboratory values. Lung disease, bedridden status, worse renal function scores, and high C-reactive protein level was more often observed in non-survivors (p<0.05). A decline in D-dimer level was more apparent in survivors; the increase in ferritin and neutrophil-lymphocyte ratio was more apparent in non-survivors (not significant). Among patients with COVID19, women had higher mean platelet volume than men (p=0.033). The rise in ferritin level was more pronounced in men, whereas the rise in neutrophil-lymphocyte ratio and platelet-lymphocyte ratio was higher in women. Conclusion: In this geriatric cohort, chronic lung disease and bedridden status were the main determinants of mortality. Moreover, different patterns of inflammatory markers may help predict the severity of COVID-19. [ABSTRACT FROM AUTHOR]

Aims/Objectives/Assumption: In Mali, malaria is the leading cause of death and consultations in health facilities. The objective of this study was to examine trends in morbidity and mortality among children aged 0 to 15 years and to establish accurate mapping of the distribution of cases in health areas of the Sélingué health district. Materials and method: A retrospective analysis of hospital records at the Sélingué district reference health center from 2010 to 2013 was conducted. Trend Chi2 and logistic regression were used, respectively, to compare changes in trends between health areas and to identify risk factors associated with malaria mortality. Results: Among the 1282 cases of malaria, the incidence of severe malaria gradually decreased from 96.75 ‰ (671 cases) in 2010 to 34.23 ‰ (291 cases) in 2011, 19.76 ‰ (168 cases) in 2012 and 19.43 ‰ (152 cases) in 2013. From 2010 to 2013, there was an average monthly variation in October of 26, 6% cerebralmalaria and 23.3% malaria anemia by the month of July of the same year. Spatial variation of anemic forms of malaria between health areas (p < 0.001) was observed from 2010 to 2013. From 2012 to 2013, there was an overall decrease in the frequency of hospitalizations, incidence and death rate for severe malaria. In multivariate analysis, in the final model, malaria lethality was associated with the duration of hospitalization for more than three days (OR = 0.124); the year of hospitalization from 2010 to 2012 (OR = 0.813); the absence of blood transfusion of the patient (OR = 0.282); at the age of the patient in children under one year (OR = 0.356) and at the emergency anti-malarial treatment instituted with artemether (OR = 3.006) adjusting for the form of malaria. On the other hand, malaria lethality was not related to the form of malaria (p = 0.072), sex (p = 0.390), residence (p = 0.308), prior treatment before hospitalization (p = 0.949). at fever in children (p = 0.153) adjusting for other variables in the model. Conclusion : Hospital case fatality remains high with a drop in the incidence of morbidity and mortality; a monthly variation in morbidity and mortality with two peaks, July - August and October- November and the emergency treatment instituted with artemether, the length of hospital stay could be identified as associated factors. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmanın amacı, böbrek hasarı olan hastalarda tedavi belirsizliklerinin nasıl giderileceğinin belirlenmesi ve tedavideki uygunsuzlukların düzeltilmesi ve önlenebilmesidir.Gereç ve Yöntemler: Kreatinin değeri >1,5 mg/dL olan ve hastanemizde son beş yılda takip edilen 438 hastanın biyokimya anabilim dalı kayıtları geriye dönük olarak değerlendirilmiştir. Hastaların demografik özellikleri, böbrek fonksiyon bozukluğu tipleri, ilişkili risk faktörleri (nefrotoksik ajanların kullanımı, cerrahi prosedürler, komorbidite, vb.), diyaliz tedavisi, komplikasyonlar ve klinik sonuçları kayıt altına alındı ve analiz edildi.Bulgular: Çalışmanın en önemli bulgusu, kaydedilmiş olan tıbbi verilerin kalitesinin çok düşük olmasıdır. En sık görülen akut böbrek hasarı tipi prerenal akut böbrek hasarı idi. Olgular arasında en yaygın etiyolojik faktörler dehidratasyon ve nefrotoksik ajanların kullanımı idi. Cerrahi işlemlerin ve eşlik eden hastalıkların böbrek fonksiyon bozukluğu gelişimini kolaylaştırdığı, gözlenen tüm komplikasyonların yaşlı hastalarda daha sık ve ciddi seyirli olduğu belirlendi. Kronik böbrek hasarı olan hastalar arasında, diyabetik nefropatisi olanların çoğunun hastaneye yatması gerekiyordu. İlginç olarak, böbrek fonksiyon bozukluğu ile izlenen yatan hastalarda en önemli mortalite nedeninin nozokomiyal infeksiyonlar olduğu belirlendi.Sonuç: Retrospektif değerlendirme için sadece birkaç tıbbi kayıt uygundu. Hastane veri toplama/depolama sistemlerinin kalitesinin iyileştirilebilmesi durumunda, bu tür çalışmalarda elde edilen araştırma verilerinin kalitesinin de aynı şekilde gelişeceğini ve bu verilerin mortalite ve morbidite konusunda önleyici ve düzeltici bir yaklaşım getirmeyi kolaylaştıracağını düşünmekteyiz.

Hypernatremia is associated with poor outcomes in critically ill patients. Hypernatremia risk factors in burned patients are not well studied. We aimed to identify hypernatremia risk factors and to evaluate outcomes in burned patients admitted to our burns intensive care unit. A case control study was conducted in adult burned patients hospitalized between January 1st 2017 and December 31st 2019. Cases who developed hypernatremia (>145 meq/L) during hospitalization were matched 1:1 with controls based on age and total burn surface area. There were 57 cases and 57 controls with a mean age of 41 ± 18 years. The majority of patients had major burns (n=99, 86.8%). The time onset of hypernatremia was seven days post burn. Compared to controls, the case group mostly consisted of transferred patients with longer time from injury to intensive care unit admission. Inhalation injury, mechanical ventilation, intravenous fosfomycin and colistin were associated with hypernatremia. Admission to the intensive care unit after six hours post-burn was the independent risk factor (OR=4.5). Hypernatremia was associated with longer length of stay and with higher mortality. We conclude that delayed management, inhalation injury, mechanical ventilation, fosfomycin and colistin administration are the main hypernatremia risk factors in burned patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Liver transplantation is still up to date as the only and definitive treatment for patients with end-stage liver failure. We examined the mortality and morbidity results of 28 patients who underwent liver transplantation in our clinic. Method: Data of 28 patients who underwent liver transplantation in our clinic between January 2018 and December 2019 were retrospectively analyzed and included in the study. Results: The mean age of patients who underwent orthotopic liver transplantation (OLT) was 51.7±12.7 years (20-73 years). Of the 28 patients, 21 were male (75%) and 7 were female (25%). The mean ejection fraction (EF) was 56.9±3.4%. The mean model end-stage liver disease (MELD) score was 22.3±5.3. After one year follow-up, 8 of 28 patients died (28.6%). Two or more units of erythrocyte suspension (ES) were given to 5 of 8 patients who died (p=0.044). Two patients received one or more units of fresh frozen plasma (FFP) (p=0.011). It was observed that administration of ES and FFP to patients increased mortality. The mean operation time of the patients who died was 12.7±0.9 hours. It was found that prolonged operation time increased mortality (p=0.027). Five patients who died were operated for the second time due to surgical complications. It was found that second operation of patients increased mortality (p=0.023). It was observed that harvesting the grafts from a living donor or cadaver had no effect on mortality (p=0.801). Conclusion: It was found that giving blood and blood products to patients who underwent liver transplantations, performing a second operation and prolonging the operation time increased mortality. [ABSTRACT FROM AUTHOR]

Objective: Pertussis is a serious public health problem and a major cause of vaccine-preventable deaths under 5 years of age. The aim of this study is to present the clinical data of the patients who were hospitalized with the diagnosis of pertussis/pertussis-like disease. Material and Methods: Hospitalized 1-4 months old infants diagnosed with pertussis/ pertussis-like disease from January 2018 to September 2018 at l were assessed retrospectively. Results: A total of 97 patients (51 males, 46 females) were diagnosed with pertussis/pertussis-like disease. Median age of the patients was 2 months (min-max 0.97-3.90). There was spasmodic cough in all cases. Thirty-two (33%) cases had abnormal lung auscultation sounds (rales and/or rhonchi), 5 cases had apnea and 36 cases had tachypnea. Nasopharyngeal smears for pertussis were taken from 31 patients (32%). Twelve from 31 nasopharyngeal smears (39%) were positive for B. pertussis using polymerase chain reaction (PCR). There was no significant difference between pertussis PCR positive group, pertussis PCR negative group and unexamined group in terms of hospital stay and age of patients. Total leucocyte and lymphocyte count in pertussis PCR positive group were significantly higher than in other two groups. Two patients were referred to the intensive care unit due to respiratory distress after their first day of hospitalization. Both received mechanical ventilator support and were discharged with cure. Conclusion: Pertussis infection causes significant morbidity and mortality in early infancy. Appropriate strategies should be developed to protect these babies. [ABSTRACT FROM AUTHOR]

Aim: To determine the frequency of malnutrition in patients with benign and malignant disease admitted to the general surgery service, evaluate the methods used in recognition of malnutrition and to investigate the role of malnutrition in the development of postoperative complications.Patients and Method: Between February 2004 and May 2005, in 723 patients, who were operated in General Surgery Department, frequency of malnutrition was detected five different methods (Nutrition Risk Index, Subjective Global Assessment, rate of weight loss, serum albumin level, Body Mass Index). Medically treated patients were excluded. Patients were followed for nutritional support, complication and mortality.Results: In 723 patients, total malnutrition rate was detected 30.5% and severe malnutrition rate was 8.9%. Patients with benign diseases, had a malnutrition rate of 25.8% despite patients with malign diseases, had a rate of 53.3%. We got highest frequencies r to determinate total and mild malnutrition with Nutritional Risk Index. For severe malnutrition, there was no differences between the methods. Complication rates were 10.9% for not malnourished patients and 28.6% for malnourished patients. Conclusion: Malnutrition is a common clinical problem in surgical patients that increases complication and mortality risks. Preoperatively detection of malnutrition and giving nutritional support to malnourished patients, may decrease complication rates.

Objective: Anemia is common in patients undergoing thoracic surgery due to three main risk factors including iron deficiency, chronic disease and iatrogenic factors, all of which can be prevented and treated. Our hypothesis was that the incidence of anemia may be higher than expected and associated with perioperative complications. Method: The data belonging to a total of 107 adult patients were included in the final analysis. We recorded demographic features, pre- and postoperative laboratory findings, comorbidities, blood transfusion rates, complications, mortality, type of surgery, rate of re-exploration,and duration of hospital stay. Results: The incidence of anemia was 43.9%, being higher in men with 57.4 percent. Anemic patients had a significantly prolonged hospital stay, higher rate of ICU hospitalizations, higher levels of pre- and postoperative creatinine and lower levels of postoperative Hb, Htc and preoperative INR (p<0.05). Conclusion: Even though the rate of mortality was not affected, anemia was associated with a higher rate of ICU admission and longer hospital stay. In order to reduce anemia-induced perioperative complications, the treatment of preoperative anemia should be considered for thoracic surgery patients. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to share our first experiences about the extracorporeal membrane oxygenator (ECMO) system that we have just started to use and compare it with the system we used before. Methods: Between January 2019 and December 2019, 27 consecutive patients under the age of 18 who were operated for congenital heart disease and needed ECMO support were retrospectively analyzed. İn this period The Medos Deltastream diagonal pump and Sorin Revolution ECMO systems were used. Results: Successful wean was observed in six (42.9%) patients in Medos ECMO group and two (15.4%) in Sorin ECMO group. Five (35.7%) patients discharged in the Medos ECMO group. In Sorin ECMO group all patients died. The difference between the groups in terms of the number of patients discharged was statistically significant (p = 0.02). Lactate clearance was 14 hours in Medos ECMO and 48 hours in Sorin ECMO (p = 0.02). Conclusion: In this study, in which we shared our first experiences regarding the first use of the Sorin ECMO system in the postcardiac pediatric patient group, we observed slower lactate clearance, lower succesful wean and higher mortaly rates. Therefore, this should be taken into account during the use of this system. [ABSTRACT FROM AUTHOR]

Objective: In this study, we evaluated the effects of body mass index on mortality and morbidity after cardiac surgery. Method: The record of 813 patients who performed open-heart surgery in our clinic were retrospectively analyzed. 505 patients with complete records were included in the study. Postoperative mortality and morbidity developments were compared in patients with a body mass index of (BMI) ≥30 kg/m2 and BMI ≤30 kg/m2 from the records. Results: 389 (%70) of patients were BMI < 30 kg/m2, non-obese (Group N), 166 of them were BMI ≥30 kg/m2, obese (Group OB). The mean age of groups (59.2±12.5, 59.6±9.6 years, respectively, p=0.65) was similar. Female gender, Diabetes Mellitus (DM), hypertension, hyperlipidemia were more common in Group OB (p<0.05). Intraoperative cardiopulmonary bypass (101±43, 98±42 p=0.26) and the duration of aortic cross clamp (64±32.7, 61.6±32.5 p=0.21) were similar. Post-operative complications of pulmonary (%19, %10) and renal (%13, %9) were significantly higher in Group OB (p<0.05), tamponade (%3.1, %0.6) and bleeding revision (%5.7, %1.8) were higher in Group N (p<0.05). Mortality occurred in 27 (5%) patients after surgery. There was no significant difference between mortality rates, ICU and hospital stay (p<0.05). Conclusion: High BMI (≥30 kg/m2) is associated with respiratory system and renal complications after cardiac surgery, and low BMI (< 30 kg/m2) is associated with morbidities such as tamponade and bleeding revision. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Health Sciences of Kocaeli University / Kocaeli Üniversitesi Sağlık Bilimleri Dergisi is the property of Institute of Health Sciences of Kocaeli University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The Global Registry of Acute Coronary Events (GRACE) risk score has a prognostic significance in patients with myocardial infarction without ST segment elevation (NSTEMI). In this study, we aimed to evaluate the significance of GRACE score at day 1 in predicting the development of in-hospital symptomatic heart failure (IH-HF) in patients presenting with NSTEMI. Material and Methods: Consecutive patients, admitted with NSTEMI between April 2016-May 2017 were evaluated in this prospective cohort study. A total of 179 patients (112 male, the mean age: 65.4±11.2) with left ventricular ejection fraction (LV-EF) <50% and N-terminal pro Btype natriuretic peptide (NT-proBNP) level >125pg/mL along with Killip Class 177.5 were found to be at higher risk for IH-HF development. Conclusion: The development of IH-HF in patients presenting with NSTEMI with asymptomatic left ventricular dysfunction significantly increases the morbidity and mortality rates. High GRACE score at day 1 in NSTEMI patients can be used to predict IH-HF. [ABSTRACT FROM AUTHOR]

Our objective was to describe the surgical neonatal visceral emergencies (SNVE) morbidity and mortality in the paediatric surgery department of the National Hospital of Lamordé in Niamey, Niger. It was an observational, prospective and descriptive study conducted over 2 years (from 1 March 2014 to 29 February 2016). Data included age at admission and sex of newborns, patient and familial medical history, diagnostic, therapeutic, and evolutive aspects of conditions. Chi-square and Student's t tests were used to compare the data of deceased and living patients. A value of p< 0.05 was considered statistically significant. SNVE accounted for 12.8 % of admissions (n = 106). The mean patient age at admission was 5.8 days (range, 0-28 days). Male predominance was observed (n = 69, 6 %). The mean birthweight was 3000 g (range, 1700-4200 g). Omphalocoele (n = 36, 33.9 %) and anorectal malformations (n = 32, 30.1 %) were the most common pathologies. Surgery was performed for 58 patients (54.7 %). The morbidity rate was 34.5 % (n = 20). The overall and postoperative mortality rates were 46.2 % (n = 49) and 46.5 % (n = 27), respectively. Septicaemia was the most common cause of death (n = 27, 55.1 %). Factors determining mortality were prematurity (P = 0.0427), low birthweight (P = 0.0185), anaemia (P = 0.0233), leucopaenia (P = 0.0004), and morbidity (P = 0.0016). Surgical neonatal visceral emergencies are frequent. Their mortality was high and favorised by prematurity, low birthweight, anaemia, leucopaenia. An antenatal and early perinatal management would improve the outcome of neonatal visceral emergencies. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The number of geriatric patients undergoing emergency surgery is increasing worldwide. The objective of our study was to retrospectively review the intensive care unit (ICU) admission rates, mortality rates and the mortality risk factors in geriatric patients undergoing emergency abdominal surgery. Materials and Method: The data of patients who underwent emergency abdominal surgery between January 2014 and August 2018 were retrospectively reviewed. Patients were classified into Group-I (=75 years) and Group-II (65-74 years). American Society of Anesthesiologists (ASA) physical status, haemoglobin values, whether preoperative cardiac examinations were conducted, ICU admission and mortality rates were recorded. The two groups were compared in terms of ICU admission rates, ICU and in-hospital mortality rates and the factors affecting these parameters. Results: A total of 109 patients were included in the study with 71 (65.1%) being in Group-I and 38 (34.9%) in Group-II. ICU admission rate and in-hospital mortality rates were higher in Group-I than those in Group-II. High ASA score in Group I and high ASA score and low haemoglobin value in Group-II affected ICU admission rate. It was observed that the absence of preoperative cardiac examination increased ICU mortality in Group-I. High ASA scores in both the groups increased in-hospital mortality. In addition, postoperative ICU admission rate increased in-hospital mortality in Group-II. Conclusion: ASA score was found to be the most important factor affecting mortality rates in geriatric patients after emergency surgery. It was concluded that ICU mortality rates can be decreased by utilising necessary treatment protocols by performing preoperative cardiologic examinations geriatric patients aged >75 years. [ABSTRACT FROM AUTHOR]

Purpose: To describe the epidemiological, clinical and therapeutic aspects of acute surgical abdomens at the Koutiala Reference Health Center. Patients and method: This was a prospective and descriptive study from August 1, 2017 to May 31, 2018. It included all patients operated on for acute abdomen in the General Surgery Department of the Koutiala Reference Health Center. The study did not include the nonoperated surgical acute abdomens, the non-surgical acute abdomens. Clavien-Dindo classification was used to evaluate complications. Results: One hundred patients were registered. Acute surgical abdomens accounted for 8.4% of consultations (n = 1190), 27.7% of surgical procedures (n = 361) and 70% of surgical emergencies (n = 142). The average age was 34.4 years ± 18.5. Men were in the majority with 70%. The mean duration of change in symptomatology was 4.8 days ± 5.4. Patients consulted for abdominal pain (100%), fever (60%), vomiting (88%) and discontinuation of materials and gases (32%). The physical examination noted abdominal distension (53%), abdominal contracture (36%), abdominal defense (56%) and pain in the cul de sac of Douglas (95%). X-rays of the abdomen without preparation and abdominopelvic ultrasonography contributed to the diagnosis in 46% of cases and 18% of cases, respectively. Acute appendicitis (35%) was the most common etiology followed by acute peritonitis (31%) and acute intestinal obstruction (15%). We performed an appendectomy in 45 patients (45%), resection anastomosis (15%) and excision-suture (13%). The average duration of hospitalization was 4.7 days. The morbidity was 12%. According to the Clavien-Dindo classification, 9 patients were grade III and 3 grade V. The mortality was 3%. Conclusion: Acute surgical abdomens are the most common emergencies in our practice. The diagnosis is clinical and para-clinical most often. Morbidity and mortality remain elevated. The outcome of treatment depends on early management and mastery of abdominal surgery techniques. [ABSTRACT FROM AUTHOR]

Objective: Assessment of the albumin, globulin score and albumin to globulin ratio (AGR) as a predictor of mortality and morbidity in patients who underwent Fontan procedure. Method: In a retrospective study, we evaluated serum albumin, globulin concentrations, and albumin- globulin ratio of 56 children who underwent Fontan procedure. Patients divided into two groups. Group 1 consisted of 44 patients who were discharged, and Group 2 consisted of 12 patients who died after surgery. Patients' preoperative and postoperative serum albumin, globulin and albumin globulin rates (AGR) were measured. Receiver-operating characteristic (ROC) curve analysis was used to determine the optimum cut-off levels of the postoperative albumin and AGR to predict mortality. Results: Twelve patients exited soon after surgeries. Postoperative albumin, and globulin values did not differ between groups, however postoperative labumin, and albumin/globulin ratios differed significantly between groups (p=0.002, and p=0.03, respectively). Cut-off value of 3,46 for postoperative albumin became an independent predictor of mortality, with 79% sensitivity, and 83% specificity. A cut-off value of 1.67 became an independent predictor for AGR with 75% sensitivity, and 89% specificity. Postoperative albumin levels below 3.46 mg/dL were associated with 11 -fold increase in the risk of mortality (OR 11; % 95CI 0,27-1,10; p=0.002). Conclusion: Postoperative albumin and AGR are a convenient and effective tool to predict the overall mortality and morbidity in patients undergoing Fontan operations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effect of a reduction in the cardiothoracic ratio (CTR) on mortality in newborns with pneumothorax. Methods: Newborns with pneumothorax, who were admitted to our neonatal intensive care unit, were included in the study. The cardiothoracic ratio was calculated by dividing the transverse cardiac diameter by maximum internal thoracic diameter. Results: Of 7909 infants admitted to our neonatal intensive care unit from September 2006 to September 2017, a total of 82 (1.03%) newborns had pneumothorax. Patients who died had a lower CTR than surviving patients (0.39±0.056 and 0.44±0.048, respectively; p<0.001). It was found that the cut-off value was 0.4, area under the curve (AUC) value was 0.79, sensitivity was 68%, specificity was 87.7%, positive predictive value was 70.8%, and negative predictive value was 86.2%. Low birth weight, preterm birth, low maternal age, presence of respiratory distress syndrome, need for resuscitation at birth, and invasive mechanical ventilation were found to be significantly associated with mortality. However, among overall significant parameters, CTR and implementation of resuscitation at birth were the independent prognostic factors determined by regression analysis (p=0.001 and p=0.036, respectively). Conclusion: A CTR below 0.4% can be considered an important parameter indicating an increased risk of mortality in newborns with pneumothorax. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine how to eliminate the treatment uncertainties, and correct and prevent inappropriate treatment in patients with renal failure. Material and Methods: We retrospectively evaluated the biochemistry department's records of 438 patients with creatinine values >1.5 mg/dL that were followed-up at our hospital for the last five years. Demographics, type of renal dysfunction, related risk factors (use of nephrotoxic agents, surgical procedures, comorbidity, etc.), dialysis treatment, complications, and clinical outcome of these patients were recorded and analyzed. Results: The most important result of the study is that the quality of the medical data recorded was very poor. The most common type of acute renal injury was prerenal acute renal injury. Among the cases, the most common etiological factors were dehydration and use of nephrotoxic agents. Surgical procedures and comorbid conditions facilitated the development of renal dysfunction, and all complications observed were more common and serious in the elderly patients. Among the patients with chronic renal injury, more of those with diabetic nephropathy required hospitalization. Interestingly, nosocomial infections were the most common cause of mortality in the patients hospitalized due to renal dysfunction. Conclusion: Only a few medical records were suitable for retrospective evaluation. We think that if the quality of hospital data collection/storage systems could be improved, the quality of research data obtained in such studies would likewise improve and these data will bring preventive and corrective approach to mortality and morbidity. [ABSTRACT FROM AUTHOR]