Browsing by Author "Polat, Gulru"

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    Clinical Characteristics and Outcomes of Nosocomial COVID-19 in Turkey: A Retrospective Multicenter Study
    (2023) Yildirim, Suleyman; Yilmaz, Celalettin; Polat, Gulru; Baris, Serap; Basyigit, Ilknur; Kaya, Ilknur; Anar, Ceyda; Bozkurt, Mihriban; Baykal, Husnu; Dirol, Hulya; Ozbey, Gamzenur; Ozsari, Emine; Cireli, Emel; Cirak, Ali; Tatar, Dursun; Gayaf, Mine; Karaoglanoglu, Selen; Aydin, Yener; Eroglu, Atilla; Olcar, Yildiz; Yildirim, Berna; Gursoy, Bengul; Yilmaz, Deniz; Niksarlioglu, Elif; Eren, Ramazan; Erdem, Aysegul; Tor, Muge Meltem; Fakili, Fusun; Colak, Mustafa; Ercelik, Merve; Tabaru, Ali; Ediboglu, Ozlem
    Objective: To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey. Methods: COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 >= 5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non survivors. Results: During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (>= 65 years) and number of comorbid diseases (>= 2) was found to be associated with mortality in nosocomial COVID-19 (OR 1.74, 95% CI 1.11-2.74 and OR 1.60, 95% CI 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 (OR 0.25, 95% CI0.16-0.38). Conclusions: Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate.
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    Evaluation of Exudative Pleural Effusions: A Multicenter, Prospective, Observational Study
    (2022) Ak, Guntulu; Metintas, Selma; Taskin, Ayse Naz; Sener, Melahat Uzel; Soyler, Yasemin; Yilmaz, Meltem; Turna, Akif; Kabalak, Pinar Akin; Bilaceroglu, Semra; Koksal, Deniz; Demirci, Nilgun Yilmaz; Sogukpinar, Ozlem; Boga, Sibel; Ercelik, Merve; Karadeniz, Gulistan; Polat, Gulru; Guldaval, Filiz; Akturk, Ulku Aka; Yilmaz, Senay; Ogan, Nalan; Yilmaz, Saliha; Esendagli, Dorina; Caglayan, Benan; Zeybek, Arife; Kocak, Nagihan Durmus; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Sarbay, Ismail; Yilmaz, Ulku; Metintas, Muzaffer; 36173482
    Purpose The aim of this study is to determine the diagnostic performances of pleural procedures in undiagnosed exudative pleural effusions and to evaluate factors suggestive of benign or malignant pleural effusions in tertiary care centers. Methods This was a multicenter prospective observational study conducted between January 1 and December 31, 2018. A total of 777 patients with undiagnosed exudative pleural effusion after the initial work-up were evaluated. The results of diagnostic procedures and the patients' diagnoses were prospectively recorded. Sensitivity, specificity, and accuracy estimates with 95% confidence intervals were used to examine the performance of pleural procedures to detect malignancy. Results The mean age +/- SD of the 777 patients was 62.0 +/- 16.0 years, and 68.3% of them were male. The most common cause was malignancy (38.3%). Lung cancer was the leading cause of malignant pleural effusions (20.2%). The diagnostic sensitivity and accuracy of cytology were 59.5% and 84.3%, respectively. The diagnostic sensitivity of image-guided pleural biopsy was 86.4%. The addition of image-guided pleural biopsy to cytology increased diagnostic sensitivity to more than 90%. Thoracoscopic biopsy provided the highest diagnostic sensitivity (94.3%). The highest diagnostic sensitivity of cytology was determined in metastatic pleural effusion from breast cancer (86.7%). Conclusion The diagnostic performance increases considerably when cytology is combined with image-guided pleural biopsy in malignant pleural effusions. However, to avoid unnecessary interventions and complications, the development of criteria to distinguish patients with benign pleural effusions is as important as the identification of patients with malignant pleural effusions.