TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Predicting Pulmonary Complications Following Upper and Lower Abdominal Surgery: ASA vs. ARISCAT Risk Index(2020) Kara, Sibel; Kupeli, Elif; Yilmaz, Hatice Eylul Bozkurt; Yabanoglu, Hakan; 0000-0002-5826-1997; 0000-0002-1161-3369; 0000-0003-0268-8999; 32259139; AAB-5345-2021; AAJ-7865-2021; AAI-8069-2021; AAK-2011-2021Objective: Postoperative pulmonary complications (POPC) account for a substantial proportion of risk related to surgery and anaesthesia. The American Society of Anesthesiologists (ASA) classification and the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk index correlate Well with POPC. Here, we compared their accuracy in predicting pulmonary complications following upper and lower abdominal surgery. Methods: We retrospectively reviewed the medical records of patients undergoing upper and lower abdominal surgery. We collected patients' demographic data, comorbidities, preoperative pulmonary risk score, laboratory results, surgical data, respiratory tract infection history within one month before surges); surgical urgency, ASA scores and pulmonary complications within one month after the surgery. Results: We evaluated 241 patients [upper abdominal surgery n=121; lower abdominal surgery (UAS) n=120; mean age 55.7 +/- 3.1 years]. In the UAS. 55.13% of the patients were male. In LAS, all patients were fitmale. In both groups, the most common POPC was pleural elfin:ion with compressive atelectasis (CA). Regarding risk score, in both groups, patients with high-risk developed a higher rate of pulmonary complications [JAS (50%), LAS 140%)]. In patients with low-risk scores, the rate of pulmonary complications was significantly lower than the intermediate and high-risk groups (p<0.001). A positive correlation was observed between preoperative risk score and complications (UAS r=0.34; LAS r=0.35 LAS p<0.05). No association was observed between the ASA scores and POPC (p=0.3). Conclusion: The ASA classification was found to be a weaker modality than ARISCAT risk index to predict pulmonary complications after the upper and lower abdominal surgeries.Item MELD-XI score predicts in-hospital mortality independent of simplified pulmonary embolism severity index among patients with intermediate-to-high risk acute pulmonary thromboembolism(2019) Ciftci, Orcun; Celik, Casit Olgun; Uzar, Guldeniz; Kupeli, Elif; Muderrisoglu, Ibrahim Haldun; 31709948Introduction: Acute pulmonary thromboembolism (PTE) is a highly morbid and fatal condition. Although several risk stratification models exist for prediction of mortality risk in PTE, no study has yet focused on the effect of impaired vital organ function, such as renal or hepatic impairment, on mortality in PTE. MELD-XI (Model for end-stage liver disease excluding INR) score predicts mortality among patients with end-stage hepatic and cardiovascular disorders. Herein, we aimed to test MELD-XI score for predicting in-hospital prognosis of patients with intermediate-to-high risk acute PTE. Materials and Methods: We reviewed the medical records patients older than 18 years hospitalized with intermediate-to-high risk PTE between 01.06.2011 and 01.01.2019. Simplified pulmonary embolism severity index (sPESI) score and MELD-XI score were calculated, and in-hospital mortality determined. MELD-XI score was compared between patients with and without in-hospital mortality and was correlated to sPESI score. The predictive power of MELD-XI score for in-hospital mortality was sought and an in-hospital survival analysis with Kaplan Meier curve and log-rank test was done for MELD-XI score. Results: A total of 104 patients [mean age of 70.8 +/- 15.9 years; 68 (65.4%) females]. Fourteen (13.5%) patients died at hospital. MELD-XI and sPESI scores were significantly correlated to each other and were higher in deceased patients than the survivors [17.3 (IQR 14.3) vs. 10.12 (IQR 2.99); p < 0.05 and 2 (IQR 1) vs. 1 (IQR 1); p < 0.05, respectively]. MELD-XI score and sPESI score were significant predictor of in-hospital mortality in multivariate analysis. A MELD-XI score >= 10.25 had a sensitivity of 78.6% and a specificity of 70.0% for in-hospital mortality. A survival analysis revealed that a high MELD-XI category (MELD-XI score >= 10.2) significantly worsened in-hospital survival (p < 0.01; log rank test). Conclusion: MELD-XI score performs well for mortality prediction among patients with intermediate-to-high risk PTE. This subject needs to be further studied by large, randomized controlled studies.