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Sukriye Miray Kilincer Bozgul,1 Ilkce Akgun Kurtulmus,2 Figen Yargucu Zihni,3 Nur Akad Soyer,4 Burcu Yagmur,5 Ajda Gunes,4 Gorkem Koymen,6 Devrim Bozkurt1 1Ege University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Izmir, Turkey; 2Torbalı State Hospital, Izmir, Turkey; 3Ege University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; 4Ege University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey; 5Ege University, Faculty of Medicine, Department of Cardiology, Izmir, Turkey; 6Izmir City Hospital, Department of Internal Medicine, Division of Medical Oncology, Izmir, TurkeyCorrespondence: Figen Yargucu Zihni, Ege University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey, Email figenyargucu@gmail.comBackground: Hemophagocytic syndrome (HPS) is a rare but life-threatening condition often complicated by heart failure (HF). This study aimed to identify predictors of acute heart failure in HPS patients using classification and regression tree (CART) analysis.Methods: A retrospective analysis was performed on 146 HPS patients without a diagnosis of HF. Variables such as age, cardiothoracic ratio (CTR), etiology, N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), ferritin, triglyceride, and lactate dehydrogenase (LDH) levels at diagnosis were included. CART analysis was employed to develop models predicting heart failure status. The model’s performance was evaluated using sensitivity, specificity, and overall accuracy.Results: This study identified several key predictors of acute heart failure in HPS patients. CTR emerged as the most significant predictor, with patients exhibiting a higher ratio being at a greater risk of developing heart failure. NT-proBNP levels and CRP levels were also significant predictors, indicating cardiac stress and systemic inflammation. Age and etiology played crucial roles, with older patients and those with rheumatological causes showing a higher susceptibility to heart failure. The CART models demonstrated good accuracy, with CTR being the most important predictor.Conclusion: This study highlights critical factors, such as CTR, NT-proBNP, CRP levels, age, and etiology in predicting acute heart failure in HPS patients. Early identification of these predictors can facilitate timely interventions, potentially improving outcomes and reducing mortality rates. These findings provide valuable insights for clinical practice and pave the way for further research on acute heart failure management in HPS.Plain Language Summary: HPS is a serious condition that can lead to heart failure, a life-threatening complication. This study aimed to identify factors that predict heart failure in HPS patients to help doctors diagnose and treat it early. By analyzing data from 146 patients, we found that a higher cardiothoracic ratio, elevated NT-proBNP levels, and increased CRP levels were strong predictors of heart failure. These findings mean that doctors can monitor these factors in HPS patients to catch heart failure early and start treatment sooner, potentially saving lives. The study also found that women with HPS might be more likely to develop heart failure, suggesting they need closer monitoring. Overall, this research provides valuable information that can improve patient care and outcomes in HPS.Keywords: hemophagocytic syndrome, acute heart failure, CART analysis, predictive factors, inflammation

Background: Intensive care unit (ICU) survival of cancer patients has improved. Urgent chemotherapy has become feasible in critically ill patients with specific organ dysfunction due to hematological malignancies., Objective: The aim of the study was to assess ICU mortality rates and the factors associated with mortality in patients with hematologic malignancies receiving urgent chemotherapy in the ICU., Methods: We retrospectively included all patients admitted to the ICU who received chemotherapy due to hematologic malignancy in 2012-2022., Results: Of the 129 patients undergoing chemotherapy in the ICU, 50 (38.7 %) died during the ICU follow-up. The following conditions were significantly more common among nonsurvivors: presence of infection at the time of ICU admission (p < 0.001), the requirement for mechanical ventilation during ICU stay (p < 0.001), the need for noninvasive mechanical ventilation during ICU stay (p = 0.014), vasopressor support (p < 0.001), and sepsis (p < 0.001). Logistic regression analysis revealed that among laboratory parameters on ICU admission, lactate (p = 0.008), albumin (p = 0.022), C-reactive protein (p = 0.046), baseline sequential organ failure assessment (SOFA) score (p < 0.001), newly developed heart failure (p = 0.006), and the requirement for vasopressor agents during ICU stay (p < 0.001) significantly influenced the risk of mortality in the univariate analysis. The multivariate analysis revealed lactate levels (p = 0.047) on ICU admission as an independent predictor of mortality., Conclusion: The development of heart failure and lactate levels on admission were the main predictors of mortality. Additionally, higher SOFA scores revealed that illness severity was closely associated with mortality. Future studies should focus on strategies to further reduce these risks and achieve the best outcomes for these patients., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2024. Published by Elsevier Masson SAS.)

Background and Aim: The aims of the present study were to evaluate the real-life efficacy and tolerability of glecaprevir (GLE)/pibrentasvir (PIB) in the treatment of patients with chronic hepatitis C (CHC)., Materials and Methods: Between May 2019 and May 2022, 686 patients with CHC, treated with GLE/PIB combination from 21 participating centers in Turkiye, were enrolled in the study., Results: All patients were Caucasian, and their median age was 56 years. At the start of GLE/PIB treatment, the median serum Hepatitis C virus RNA and serum alanine amino transaminase (ALT) levels were 6.74 log10 IU/mL and 47 U/L, respectively. Fifty-three percent of the patients were infected with genotype 1b, followed by genotype 3 (17%). Diabetes was the more common concomitant disease. The sustained virological response (SVR12) was 91.4% with intent-to-treat analysis and 98.5% with per protocol analysis. The SVR12 rates were statistically significant differences between the patients who were i.v. drug users and non-user (88.0% vs. 98.8%, p=0.025). From the baseline to SVR12, the serum ALT levels and Model for End-Stage Liver Disease score were significantly improved (p<0.001 and p=0.014, respectively). No severe adverse effect was observed., Conclusion: GLE/PIB is an effective and tolerable treatment in patients with CHC., Competing Interests: The authors have no conflict of interest to declare., (© Copyright 2023 by Hepatology Forum.)