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Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni 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 Population & Sociétés is the property of Institut National d'Etudes Demographiques 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 British Journal of Canadian Studies is the property of Liverpool University Press / Journals 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 Firat Universitesi Sağlik Bilimleri Tip Dergisi is the property of Firat Universitesiu, Saglik Bilimleri Enstitusu 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.)

Over half of the growing global stroke-mortality burden is accounted for by the East-Asian-subcontinent alone. Sex differences in stroke-mortality in the Asian population is yet to be assessed in the literature. We aimed to assess the sex-differences in mortality following stroke in a large cohort of Thai-patients. All stroke admissions between 2004–2015 were included from the Thailand public-health-insurance-database. The association between sex and mortality was assessed in-hospital, at 1 month, 1 year and 5 years, using multivariable Cox-regressions, separately for ischaemic-stroke (IS), haemorrhagic-stroke (HS) and stroke-of-undetermined-type(SUT), adjusting for confounders. 608,890 patients were included: 370,527 patients with IS(60.9%), 173,236 with HS(28.5%) and 65,127 with SUT(10.6%). Women were older than men in all three groups and had higher prevalence of comorbidities. Adjusted hazard-ratios(HRs) of mortality showed women had higher mortality post-IS compared to men (in-hospital: HR: 1.20; 95% CI: 1.17–1.23; 1 month: HR: 1.17; 95% CI: 1.15–1.20; 1 year: HR: 1.10; 95% CI: 1.09–1.12 and 5 years: HR: 1.02; 95% CI: 1.01–1.03). Women also had higher mortality after HS (in-hospital: HR: 1.02; 95% CI: 1.00–1.04; 1 month: HR: 1.08; 95% CI: 1.06–1.10; 1 year: HR: 1.04; 95% CI: 1.03–1.06 and 5 years: HR: 1.09; 95% CI: 1.08–1.11), and SUT (in-hospital: HR: 1.04; 95% CI: 1.03–1.06; 1 month: HR: 1.20; 95% CI: 1.14–1.27; 1 year: HR: 1.14; 95% CI: 1.09–1.18 and 5 years: HR: 1.06; 95% CI: 1.03–1.10). Compared to men, women were older at time of stroke-diagnosis and had higher burden of stroke risk-factors. Women also had higher mortality after stroke regardless of stroke-type or duration since stroke-onset. Post-IS, excess stroke-mortality in women was greatest during the in-hospital period, whereas excess stroke-mortality increased with time in women who had HS. No clear relationship was found between duration since stroke-onset and mortality in patients who had SUT. [ABSTRACT FROM AUTHOR]

Although individual estimates of life expectancy are readily available, analogous couple-based estimates are not. The dearth of such estimates can be detrimental for couples undertaking important decisions together, such as retirement, savings, and other later-life considerations. Moreover, relying on available individual measures can be misleading because it results in overestimating the number of years the couple should expect to live together (joint life expectancy) and underestimating the number of years the widowed spouse expects to live (survivor life expectancy). In this article, we use data from the Longitudinal Administrative Database to provide benchmark estimates for joint and survivor life expectancy for Canadian couples and show how these estimates vary with the income and employment status of couples approaching retirement. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Research in Health Sciences (JARHS) / Sağlık Bilimlerinde İleri Araştırmalar Dergisi (SABİAD) is the property of Journal of Advanced Research in Health Sciences (JARHS) 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: Improvement of surgical outcomes in emergency laparotomy surgery remained dubious. Physiology and Operative Severity Score for the enumeration of Mortality (POSSUM) and Portsmouth-POSSUM (P-POSSUM) have been validated in multiple studies. The objective of this study is to determine the value of both as surgical audit tool predicting the morbidity and mortality of emergency laparotomy in a single tertiary centre in Malaysia. Methods: A retrospective review was performed in Hospital Universiti Sains Malaysia after obtaining ethical approval. All adult subjects that underwent emergency abdominal surgery from 2012 until 2015 were reviewed. Data collected were subjects' demography, clinical-pathological profiles and clinical pathway characteristics. Expected morbidity and mortality were calculated using POSSUMs risk prediction model and subsequently compared against the observed outcome. The risk prediction model was analyzed using Hosmer and Lemeshow Goodness of Fit statistical test. Results: Eighty-three (83) subjects were analyzed in this study. The proportion of 30-day in-hospital morbidity was 44 (53.0%) subjects and in-hospital mortality was 12 (14.5%) subjects. Eighteen subjects that developed in-hospital morbidity had suffered a respiratory complication. The observed-to-expected ratio of POSSUM predicting morbidity was 0.9 and P-POSSUM predicting morbidity was 0.8. However, using Hosmer and Lemershow Goodness of Fit statistical analysis, the p-value of less than 0.05 showed both POSSUM and P-POSSUM predicted poor morbidity and mortality across all risk stratifications in this population. Conclusions: POSSUM and P-POSSUM are not suitable for surgical audit tool in this centre because both produce a poor prediction of in-hospital morbidity and mortality in emergency laparotomy. [ABSTRACT FROM AUTHOR]

Objective: In the early stages of the worldwide coronavirus disease 2019 (COVID-19) pandemic, there aren’t many secondary intensive care unit publications. In our study, it was aimed to calculate the mortality rate and to determine the factors affecting mortality by retrospectively evaluating the data of COVID-19 patients hospitalized in a secondary intensive care unit. Methods: The files and records of patients aged 18 years and older who were positive for reverse transcriptase-polymerase chain reaction and followed in the secondary COVID-19 intensive care unit between January 2020 and July 2021, and their records in the hospital information system, were evaluated retrospectively. Demographic data, laboratory parameters, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and clinical data of the patients were recorded. The data of living and deceased patients were compared. Regression analysis was performed for data with risk factors. Results: Archive records of a total of 227 patients were reviewed. The all cause mortality rate was 53.3%, and the median length of stay in the intensive care unit was 5 years. There was a significant difference in age (p<0.001), need for invasive mechanical ventilation (p<0.001), hospitalization saturation (p=0.016), ferritin (p<0.001), D-Dimer p(<0.001), APACHE II (p<0.001) and SOFA (p<0.001) scores between the living and deceased patient groups. Conclusion: Due to the increased number of patients and workload at the beginning of the COVID-19 pandemic, patient follow-up was carried out under difficult conditions in all intensive care units, especially in the secondary care units. In this period, we think that easily accessible biomarkers that can be used to predict mortality in secondary intensive care units may play a role in planning the treatment and referral processes of patients, and may have positive effects on patient outcomes by using the facilities more efficiently. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare laboratory and outcome of the patients who were hospitalized in the intensive care unit with the diagnosis of Coronavirus Disease-19 (COVID-19) and transfused convalescent plasma based on timing of treatment. Methods: Patients administered 200 mL of convalescent plasma were analysed retrospectively. Based on symptoms’ onset, patients were divided into two groups as early (≤ 7 days) and late (> 7 days) plasma treatment groups. Patients’ characteristics, comorbidities, treatments, laboratory (pre-transfusion, day 1 and day 3 after transfusion) and outcome were evaluated according to groups. Results: A total of 152 patients matched criteria. There was no difference between the early (n=82) and late (n=70) treatment groups in terms of demographic characteristics, comorbidities, treatments, outcomes. Ferritin levels were higher in the early treatment group than in the late treatment group on before transfusion and day 1 (p=0.023, p=0.015). C reactive protein value was lower in the late treatment group on day 3 (p=0.011). Comparing the rate of change between day 1 and day 3 of treatment, it was observed that the changes in ferritin and fibrinogen values were higher in the late group than in the early group (p=0.014, p=0.049). There was no difference between the groups in other laboratory values and outcome. Conclusion: In our study, we observed that the timing of convalescent plasma had no significant effect on outcome. However, more evidence was needed to prove the difference in laboratory results. [ABSTRACT FROM AUTHOR]

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?. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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]

Purpose: The aim of the study was to evaluate the mortality prediction performances of delta bicarbonate, delta anion gap, and delta ratio in methanol poisoning (MP) cases. Materials and Methods: This clinical study, which followed a cross-sectional study design, involved patients with MP who were still alive when they initially arrived at the emergency department of a tertiary care hospital. Patients were divided into two groups mortality and nonmortality. Patients who died during treatment and followup were assigned to the mortality group, while others were assigned to the non-mortality group. Receiver Operating Characteristic (ROC) analysis was used to determine the cut-off in the diagnostic value measurements of biomarkers predicting mortality. Results: Nine (20%) of the 45 patients in the study died during their follow-up. The two groups showed a significant difference in the averages of pH, bicarbonate (HCO3-), lactate, anion gap, delta anion gap, delta HCO3-, and delta ratio, but not in the averages of partial carbon dioxide pressure (pCO2). In predicting mortality, pH, anion gap, and delta anion gap were found to have outstanding diagnostic power (AUC>0.9), while HCO3-, delta HCO3-, delta ratio were found to have acceptable diagnostic power (AUC: 0.7-0.8). Conclusion: Delta anion gap, delta bicarbonate, and delta ratio can be used as prognostic factors in predicting mortality in MP cases. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine factors affecting mortality and survival after Percutaneous endoscopic gastrostomy (PEG) in patients who were hospitalized in the neurology intensive care unit during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: The clinical and demographic data of 29 patients aged 18 years and older who received PEG tube insertion during hospitalization in the Neurology Intensive Care Unit of Bursa City Hospital, Turkey, between February 2020 and May 2021 were examined retrospectively. Patients' demographics, clinical characteristics, and survival status were recorded. Results: We included 29 patients (16 females and 13 males) into our study. Median age was 71 (33-89) years among survivors and 75.5 (48-90) years among those who died. The groups were similar with respect to age (p = 0.119) and sex (p = 0.806). Mortality rate after PEG insertion was 66%. Mean overall survival after PEG tube insertion was 129.49 days (95% CI: 91.21-167.78). Cox regression revealed that having multiple comorbidities was associated with increased the likelihood of mortality by 2.822-fold (95% CI: 1.001-7.968, p = 0.049). Conclusions: These findings show that having multiple comorbidities was the most important factor associated with mortality among PEG recipients who were admitted to the Neurology Intensive Care Unit during the COVID-19 pandemic. Since multiple comorbidities cause shorter survival, it appears that the decision to insert PEG tubes must be made extremely cautiously among these patients. However, more comprehensive studies should be conducted to clarify the effect of COVID-19 on mortality rates and survival time after PEG. [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 Bosphorus Medical Journal / Boğaziçi Tıp 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 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.)

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY 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 Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY 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 Turkiye Klinikleri Journal of Internal Medicine / Türkiye Klinikleri İç Hastalıkları Dergisi is the property of Turkiye Klinikleri 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 Pediatric Emergency & Intensive Care Medicine / Çocuk Acil ve Voğun Bakım Dergisi 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 Public Health is the property of Turkish Journal of Public Health 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: 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.

Objective: Uric acid (UA) is a molecule whose effect on cerebrovascular diseases, hypertension, and diabetes has been investigated. Conflicting results have been obtained in studies examining the relationship between ischemic stroke and UA. The previous studies have found that both high and low UA levels are associated with poor prognosis in stroke patients. Therefore, we investigated the effects of UA levels on mortality, stroke severity, and clinical outcome in ischemic stroke. Methods: The patient demographics, chronic diseases, serum UA (SUA) levels, National Institutes of Health Stroke Scale scores, and modified Rankin scale (mRS) scores were recorded. The patients were divided into three groups based on SUA levels below 3.59 mg/dL, between 3.59 mg/dL and 8.5 mg/dL, and above 8.5 mg/dL. Pearson's Chi-square test was used to compare the data. Results: A total of 820 patients were included in the study and 42.4% of them were women. The mean age was 68.53 years. SUA levels were lower in women. Moderate and moderate-to-severe strokes, a high mortality rate, poor neurological outcomes, and the need for intensive care and mechanical ventilation were most common in the patients with SUA levels above 8.5 mg/dL followed by the group with SUA levels below 3.59 mg/dL. The lowest mortality, best neurological outcomes, most cases of moderate stroke, and least need for intensive care and mechanical ventilation were in the group with SUA level between 3.59 mg/dL and 8.5 mg/dL. Conclusion: UA has both oxidant and antioxidant properties and its effect is level dependent. The best prognosis was seen in the group with SUA levels of 3.59-8.5 mg/dL. Therefore, maintaining the UA levels within this range when following ischemic stroke patients might reduce mortality and morbidity. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine whether the addition of decade and gender to quick Sequential Organ Failure Assessment (qSOFA) is superior to qSOFA alone in predicting the mortality of sepsis patients presented to our emergency department. Methods: We included 300 sepsis patients in our study. The gender with higher mortality received 1 more point. We added the qSOFA score and decade to this value and compared qSOFA and the new scoring system to predict mortality. Furthermore, we determined a cutoff value for age to systolic blood pressure to predict mortality. Results: Forty-six percentages of our patients were female, and 54% were male. Patients in their 80s (34%) and 90s (26%) comprised the majority of the study group. Mortality rates were higher in males when compared with females. Mortality rate was positively related with age and systolic blood pressure. The cutoff value for age and systolic blood pressure was 0.71 (AUC: 0.799, CI: 0.750-0.848, p=0.00). Patients were at higher risk for mortality if their ratio of age to systolic blood pressure was higher than 0.71 (OR: 2.58). We added a decade and one more point to the qSOFA for the male gender and compared this value with the qSOFA score. The new scoring system (qSOFA+decade+male gender +>0.71) (CI: -2.49--1.67) was superior to qSOFA alone to predict (CI: -1.20--0.80) mortality. Conclusion: Age to systolic blood pressure ratio alone can also predict mortality better than qSOFA. The qSOFAm scoring system may be useful in determining the mortality of sepsis patients. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to investigate the effects of pneumothorax (PX), a rare complication of COVID-19, on mortality. Methods: All patients admitted to our hospital with the diagnosis of COVID-19 were screened, and patients who developed PX were included in the study. Patient demographics data, number of days of hospitalization for comorbidities, day and duration of thorax tube insertion, and laboratory findings during hospitalization were recorded by scanning the hospital automation system and patient records. Results: For our study, 7485 patients hospitalized with the diagnosis of COVID-19 were screened in intensive care unit. PX was detected in 32 (0.296%) of the patients. About 59.4% of these patients included in the study were male. DM was the most common comorbid condition at 56.3%. In these patients, the mortality rate was found to be 90.6%. Conclusion: The data obtained indicate that PX, a COVID-19 complication, leads to a serious increase in mortality. We believe that using protective ventilation methods to avoid the development of pneumotarax will help to reduce mortality. Keywords: COVID-19, mortality, pneumothorax [ABSTRACT FROM AUTHOR]

Objective: Bronchoscopy is important for the diagnosis and treatment planning of patients in the intensive care unit, especially for infectious conditions. However, increasing evidence is reported in recent guidelines showing that bronchoscopic sampling is not superior compared with endotracheal aspirate (ETA). This study aimed to evaluate the contribution of bronchoscopic sampling to antibiotic treatment and its effect on intensive care mortality. Materials and Methods: This retrospective observational study evaluated the data of 75 patients who were followed up under invasive mechanical ventilation using the intensive care fiberoptic bronchoscopy (FB) database. Results: The mean age of patients was 66.0±15.4 years, and 28 (37.32%) were female and 47 (62.7%) were male. The mean acute physiology and chronic health evaluation-II score was 23.1±6.2. Median FB timing was 7.0 (2.0-15.0) days after the intensive care unit admission. Indications for FB were infection evaluation in 44 patients, airway evaluation in 26 patients, hemoptysis-alveolar hemorrhage in 3 patients, and interstitial lung disease suspicion in 2 patients. Active immune suppression was present in 24 (32%) patients. Evaluation of ETA results revealed bacterial and fungal growth in 31 patients (41.3%). After FB sampling, 41 patients (54.6%) were found to have bacterial and fungal growth, and treatment was changed in 16 (21.3%) patients with FB sampling. However, no significant relationship was found between the change of treatment after FB and mortality in the intensive care unit (p=0.250). Conclusion: Our study has two important results. First, ETA and FB sampling results were found to be similar. Second, no correlation was found between treatment change after FB in the late period and mortality in intensive care. The application of FB, which is an invasive procedure, could be the right approach in selected patients. [ABSTRACT FROM AUTHOR]

Objective: Scoring systems can be used to determine the severity of injury, triage, and create epidemiological data. This study evaluated the performance of scoring systems. Materials and Methods: A total of 130 patients who are admitted to the intensive care unit (ICU) with multitrauma diagnosis were included in the study. The demographic characteristics of patients, length of stay in mechanical ventilation and ICU, mortality rates, and scores from scoring systems were calculated and recorded. Results: When the relationship between the age groups of patients and mortality was examined, a statistically significant difference was found in the mortality rate in patients >65 years of age (65.2%), in patients 18-65 years of age (36.7%), and in patients <18 years of age (23.5%), which was found to be higher. The Glasgow coma scale/score (GCS), revised trauma score (RTS), acute physiology and chronic health evaluation-II (APACHE-II), trauma injury severity score (TRISS), injury severity score (ISS), simplified acute physiology score II (SAPS II), extended SAPS II, and sequential organ failure assessment (SOFA) scores in the average of living patients were 9.94±4.09, 5.95±1.34, 11.46±6.18, 20.30±7.45, 14.86±10.20, 24.27±15.33, 3.98±1.34, 4.81±1.52, respectively, whereas the mean scores of patients with mortality were 5.40±2.19, 2.95±0.70, 31.96±6.79, 40.19±9.51, 43.60±16.95, 62.73±13.96, 5.69±1.88, 6.54±4.20, respectively. The average length of stay in the ICU was 11.55±16.12 days. Conclusion: When the scoring systems used in the ICU are compared, the GCS, RTS, TRISS, APACHE-II, SAPS II, and broad SAPS II can be used as a predictor of mortality; however, a meaningful result could not be obtained between the SOFA score and mortality prediction. Our study results revealed that scoring systems are efficient in predicting the duration of stay in the ICU and mechanical ventilation. [ABSTRACT FROM AUTHOR]

Background: COVID 19 continues to affect the whole world with its different presentations and unenlightened aspects. Older patients are the group most at risk. Low hemoglobin levels contribute to hypoxia during COVID 19 infection and increase the risk of complications, especially in risky groups. In this study, we aimed to investigate the prevalence of anemia and its effect on mortality in geriatric COVID 19 patients. Materials and Methods: Data of 251 patients over the age of 65 who were followed up in the Internal Medicine services allocated for COVID 19 of our hospital between August and October 2020, were included in the study. Anemia was defined as a hemoglobin level of 13 mg/dl in men and below 12 mg/dl in women at the time of admission. Demographic and laboratory data of the patients and hemoglobin levels were compared. Results: The mean age of 251 COVID-19 patients included in the study was 75.6±7.6 years. 45.8% (n:115) of the patients were female and 54.2% (n:136). While 51.8% of the patients had anemia, the presence of anemia was found to be 67.9% in patients who died due to COVID 19. According to multivariate logistic regression analysis, advanced age (OR=1.082; 95% CI=1.03-1.137; p=0.002), presence of anemia (OR=1.969; 95% CI=1.113-4.246; p=0.034), hypertension (OR =5.763; 95% CI=1.713-19.389; p=0.005), dementia (OR=3.614; 95% CI=1.128-11.578; p=0.031) were determined as independent risk factors predicting mortality in patients with COVID-19. Conclusion: Advance age, presence of anemia, hypertension and dementia has been found as İndependant risk factors for mortality in COVID 19 infection in our study. In elderly Covid 19 patients hemoglobin levels at admission may be helpful in predicting mortality. [ABSTRACT FROM AUTHOR]

Objective: Incidence of ventilator-associated pneumonia, caused by gram-negative multidrug resistant bacteria, is on the increase and early mortality rate is high. We aimed to investigate the effects of aging, comorbidities, high Charlson comobidity index score, high Acute Physiology and Chronic Health Evaluation II score, leukocytosis, high C-reactive protein level, inappropriate empirical antibiotic therapy and antibiotic resistance on mortality in ventilator-associated pneumonia caused by gram-negative multidrug-resistant bacteria. Methods: The study was planned as a retrospective cohort study. Patients aged 18 years and older who were hospitalized between January 01, 2015, and January 01, 2020, diagnosed with ventilator-associated pneumonia, and had Gram-negative multidrug resistant pathogen was detected in blood and/or bronchoalveolar lavage fluid specimen or quantitative endotracheal aspirate cultures were included in the study. Results: A total of 370 patients were included in the study. Median age of the patients was 74 (19-95) years. Most frequent bacteria was Acinetobacter baumannii (52.4%). Resistance to ceftriaxone, meropenem, and colistin was 99%, 68%, and 4%, respectively. 7-day and 21-day mortality rates were 38.3% (n=142) and 85.1% (n=315). In multivariate analysis, 7-day mortality was associated with a Charlson comorbidity index score of =4, and risk factors for 7-day mortality were septic shock, amikacin resistance, and white blood cell count =15000/mm3. Advanced age was found to be a risk factor for 21-day mortality, and a high Acute Physiology and Chronic Health Evaluation II score and a high Charlson comorbidity index score were associated with 21-day mortality. It was found that the risk of 7-day mortality in patients with tracheostomy was lower than in patients without tracheostomy. Conclusion:Consideration of clinical scoring systems, closer monitoring of elderly patients, following-up with tracheostomy, may provide a decrease in mortality of ventilator-associated pneumonia, caused by multidrug resistant pathogens. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Agriculture & Nature / Kahramanmaraş Sütçü İmam Üniversitesi Tarım & Doğa Dergisi is the property of Kahramanmaras Sutcu Imam Universitesi 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.)

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BACKGROUND: Elderly patients with hip fractures have a high post-operative 1-year mortality rate. The aim of this study was to investigate the relationship of the neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (TLR), and monocyte/lymphocyte ratio (MLR) with mortality. METHODS: The data of 350 patients who suffered femoral intertrochanteric fractures between January 2015 and January 2020 were examined, and the demographic data of 124 patients who met the study criteria were evaluated. During the 1-year follow-up, 92 patients (74%) who continued their lives and 32 patients (25%) who died were divided into two groups: Group 1 (survivors) and Group 2 (non-survivors). NLR, TLO, MLO, presence of comorbidities, age, sex, American Society of Anesthesiologists Physical Status Classification, length of hospital stay, fracture type, and fracture pattern values were statistically compared between the two groups. RESULTS: NLR, TLR, and MLR are the laboratory parameters assessed within the scope of the study. Preoperatively, the mean NLR was 6.59 (1.61--26.29), mean TLR was 197.94 (86--516), and mean MLR was 0.73 (0.19--15.68). In this study, a significant relationship was found between NLR, TLR, and MLR values and the occurrence of post-operative 1-year mortality (p=0.01). In addition, the result was significant in the correlation between these parameters. Cutoff values were found to be 7.53 for NLR, 192 for TLR, and 0.54 for MLR in receiver operator characteristic curve analysis (p<0.01). CONCLUSION: NLR, TLR, and PLR are significant predictors of 1-year mortality in patients aged over 60 years with hip fractures. [ABSTRACT FROM AUTHOR]

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