Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item The role of neutrophil-to-lymphocyte ratio in predicting disease progression and emergency surgery indication in benign intestinal obstructions(2022) Tasci, Halil Ibrahim; 36043932BACKGROUND: The physiological response of the immune system to various stress factors results in an increase in neutrophil count and a decrease in lymphocyte count. In the light of this information, some studies have suggested using the ratio of these two parameters as an infection marker. The aim of this study was to investigate the role of neutrophil-to-lymphocyte ratio (NLR) derived from complete blood count, a very cost-effective and rapidly measurable parameter, in predicting the urgency of the surgical indication and disease progression in intestinal obstructions secondary to benign causes. METHODS: The data of patients who were admitted with the diagnosis of intestinal obstruction secondary to benign causes and underwent surgical intervention between January 2010 and January 2021 in Baskent University, Faculty of Medicine, Department of General Surgery, Konya Practice and Research Hospital were retrospectively analyzed. The data of 109 patients who met the study criteria and were included in the study were statistically analyzed. The correlation of admission NLR with factors indicating the severity of the disease such as intraoperatively detected ischemia, perforation, resection requirement, post-operative morbidity and mortality, and length of hospital stay was examined. Moreover, the diagnostic value of the NLR was compared with that of other infection mark-ers (such as C-reactive protein [CRP] and leukocyte). RESULTS: It was observed that the high NLR during admission to the hospital due to benign intestinal obstruction causes signif-icantly increased the risk of ischemia, resection requirement, post-operative complications, and mortality during surgery (p<0.05). Furthermore, increased NLR was found to be associated with prolonged hospitalization. In correlation analysis, consistent with the literature, a positive correlation was found between NLR and hospitalization time (p=0.03), CRP value (p<0.001), ischemia (p<0.001), perforation (p=0.007), presence of post-operative complications (p=0.009), and mortality (p=0.002). CONCLUSION: Our results show that the NLR has a very important role in predicting the course of the disease and surgical in-dication in benign intestinal obstructions.Item Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey(2020) Tekkarismaz, Nihan; Torun, Dilek; 0000-0001-7631-7395; 0000-0002-6267-3695; 32041385; AAD-9088-2021; AAD-9111-2021Background/aim: The aim of this study was to evaluate the clinical outcomes and identity the predictors of mortality in peritoneal dialysis patients. Materials and methods: Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May 2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to haemodialysis or the end of the study Results: A total of 242 patients were included in thestudy: The incidence of peritonitis was 0.18 (ranging from 0 to 14.9) episodes per patient year. Death occurred in 280 (n: 68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independent risk factors for all-cause mortality according to multivariate analysis. 'the presence of comorbid disease and diabetes mellitus and patients aged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated with increased risk of mortality Between peritonitis and peritonitis-free group, there was no significant difference in Kaplan-Meier curves in terms of patient survival. Conclusion: This is the first study to define 9-year mortality predictors in PD patients in our centre. Although peritonitis is the most feared complication of PD, our study showed that peritonitis did ot reduce patient survival.Item Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients(2020) Kaya, Hakki; Sahin, Anil; Gunes, Hakan; Bekar, Lutfu; Celik, Ahmet; Cavusoglu, Yuksel; Caldir, Vedat; Gungor, Hasan; Yilmaz, Mehmet Birhan; 32812491Background Relationship between the frequency of occurrence of bendopnea during the daily life of heart failure (HF) outpatients and clinical outcomes has never been evaluated before. Methods Turkish Research Team-Heart Failure (TREAT-HF) is a network between HF centres, which undertakes multicentric observational studies in HF. Herein, the data including stable 573 HF patients with reduced ejection fraction out of seven HF centres were presented. A questionnaire was filled by the patients, with the question 'Do you experience shortness of breath while tying your shoelace?', assessing the presence and frequency of bendopnea. Results To the question related to bendopnea, 48% of the patients answered 'yes, every time', 31% answered 'yes, sometimes', and 21% answered 'No'. Patients were followed for an average of 24 +/- 14 months, and the patients who answered 'yes, every time' and 'yes, sometimes' to the bendopnea question were found having increased risk for both HF-related hospitalisations (HR:3.2,p < .001- HR:2.8,p = .005) and composite outcome consisting of 'HF-related hospitalisations and all-cause death in the multi-variate analysis (HR:3.1,p < .001- HR:3.0,p < .001). Kaplan Meier analysis for HF-related hospitalisation, all-cause death, and the composite of these were provided for these three groups, yielding significant and graded divergence curves with the best prognosis in 'no' group, with the moderate prognosis in 'sometimes' group, and with the worst prognosis in the 'every time' group. Conclusion For the first time in the literature, our study shows that the increased frequency of bendopnea occurrence in daily life is associated with poor outcomes in HF outpatients.Item SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit?(2019) Toker, Melike Korkmaz; Gulleroglu, Aykan; Karabay, Ayse Gul; Bıcer, Ilhan Guncey; Demiraran, Yavuz; 31135940BACKGROUND: The aim of the present study was to evaluate the effectiveness of the Simplified Acute Physiology Score (SAPS) III and the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the prediction of in-hospital mortality in surviving multi-trauma patients. METHODS: This study was conducted in the 13-bed intensive care unit (ICU) of a tertiary hospital. A retrospective review of multi-trauma patients whose care was managed in the ICU was performed. Data collection included details of age, gender, ICU admission, and outcome. APACHE IV and SAPS III scores, as well as the predicted mortality rate (PMR), were calculated using web-based calculators. RESULTS: Of the 90 patients 20% (n= 18) were female and 80% (n= 72) were male. The overall mortality rate was 25.6%. The mean APACHE IV, Acute Physiology Score (APS) and SAPS III score was 69.27 +/- 34.51, 66.42 +/- 33.72, and 26.36 +/- 27.14, respectively. The mean PMR according to the APACHE IV and the SAPS III was 26.36 +/- 27.14 and 17.07 +/- 24.88, respectively. The area under the curve result of receiver operating characteristic curve analysis was 0.87 for the APACHE IV and 0.93 for the SAPS III. CONCLUSION: The performance of the SAPS III was more sensitive and discriminative than the APACHE IV scoring system for multi-trauma ICU patients.Item Neutrophil/lymphocyte ratio and Red blood cell distribution width are independent risk factors for 30-day mortality in Gastrointestinal system bleeding patients(2019) Altinbilek, Ertugrul; Ozturk, Derya; Kavalci, CemilBackground. In this study, we aimed to examine demographic and endoscopic features of patients with GI bleeding to determine the factors affecting 30-day mortality. Method. Patient's demographic features, laboratory outcomes, comorbidities, drug use, endoscopy outcomes, Glasgow-Blatchford scores, and mortality status were examined. The factors affecting 30-day mortality were investigated. Results. The mean age of the patients was 58.2 +/- 17.4 years, and 72.1% were male patients. 30-day mortality rate was found to be 14.4%. The mean age of patients who died was high (p<0.05). The incidence of mortality was high in the presence of comorbidity, malignancy, and cirrhosis (p<0.05). Systolic blood pressure was low in the patients who died (p<0.05). No significant correlation was found between mortality and gender, symptoms, predisposing factors, lesion type and Forrest score, diastolic blood pressure and heart rate (p>0.05). Urea, neutrophils, red blood cell distribution width / platelet ratio, neutrophil / lymphocyte ratio and RDW levels were high, and hemoglobin level was significantly low in patients with a mortal progression (p<0.05). No significant correlation was found between mortality, and platelet and lymphocyte levels (p>0.05). Glasgow-Blatchford score was significantly higher in patients who died (p<0.05). Conclusion. Many factors affect 30-day mortality in GI bleeding. It should be remembered that follow-up of patients with an advanced age who have comorbidity and impaired hemodynamics should be kept for long, and that these patients are at a high risk for mortality. According to our results, NLR and RDW are independent factors that determine the 30-day mortality in upper GI bleeding.Item The relation of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with stage I-III non-metastatic colon cancer(2016) Bedir, Osman; Kiziltas, Safak; Kostek, Osman; Ozkanli, Seyma; 27210779Background/Aims: To evaluate the association of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with colon cancer. Materials and Methods: A total of 132 patients-with a mean (standard deviation; SD) age of 63.0 (10.0) years and of whom 56.0% were males-with non-metastatic stage I-III colon cancer were included. Symptoms prior to diagnosis were evaluated with respect to tumor localization, tumor node metastasis (TNM) stage, histological grade, and postoperative 3-year mortality. Results: Constipation and abdominal pain were the two most common symptoms appearing first (29.5% and 16.7%, respectively) and remained most predominant (25.0% and 20.0%, respectively) up to diagnosis. The frequency of admission symptoms significantly differed with respect to tumor location, TNM stage and histological grade. The postoperative 3-year survival rate was 61.4%. Multivariate logistic regression revealed that melena and rectal bleeding increased the likelihood of 3-year mortality by 13.6-fold (p=0.001) and 4.08-fold (p=0.011), respectively. Conclusion: Our findings revealed differences in presenting symptom profiles with respect to the time of manifestation and predominance as well as to the TNM stage, histological grade, and tumor location. Given that melena and rectal bleeding increased the 3-year mortality risk by 13.6-fold and 4.08-fold, respectively, our findings indicate the association of admission symptoms with outcome among patients with colon cancer.