Browsing by Author "Soylu V.G."

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Assessment of the relationship between C-Reactive Protein/Albumin ratio and 28-day mortality in critically very elderly patients (≥ 85 years) with acute ischemic stroke
(2022-01-01) Soylu V.G.; Karahan E.; Yılmaz A.; Taşkın Ö.; Demir U.
Background & Objectives: The aim of this study is investigate the relationship of C-reactive protein, albumin, C-reactive protein/albumin ratio with prognosis and 28-day mortality in critically ill patients over 85 years of age with acute ıschaemic stroke. Methods: This study is a retrospective and observational study. A total of 189 patients aged 85 years and older who were followed up in the intensive care unit between 2017 and 2020 were included in the study. Demographic data of the patients included in the study, length of stay in the intensive care unit, comorbidities, laboratory data of hospitalization in the intensive care unit, C-reactive protein, albumin, C-reactive protein/albumin ratio, neutrophil/lymphocyte ratios, thrombocyte/lymphocyte ratios, APACHE II, SAPS II values of intensive care admissions were recorded. Results: In the statistical analysis performed for C-reactive protein, albumin, C-reactive protein/albumin ratio between survival and non-survival groups, a statistically significant difference was found between the groups (For C-reactive protein, p = 0.03; for albumin, p = 0.02; for C-reactive protein/albumin ratio, p= 0.03). The logistic regression model was applied to investigate the independent risk factors affecting the patients’ mortality at 28 days. Albumin, CRP, C-reactive protein/albumin ratio was found to be associated with 28-day mortality according to the logistic regression analysis. (For albumin; p= 0.04, for C-reactive protein; p= 0.04, for C-reactive protein/albumin ratio; p= 0.04). According to the ROC curve analysis result, Cut-off value was found to be 2.47 for C-reactive protein/albumin ratio. Conclusion: The CRP/albumin ratio is a valuable parameter that can be used to predict 28-day mortality in critically ill very elderly patients with acute ischemic stroke.
Association Between Prognostic Nutrition Index, Geriatric Nutrition Risk Index and 28-Day Mortality in Critically Very Elderly Patients (≥85 Years)
(2023-06-01) Soylu V.G.; İnan F.Ç.; Yılmaz A.; Taşkın Ö.; Demir U.
Background/Purpose: The aim of this study is to association the Prognostic Nutrition Index(PNI) and Geriatric Nutrition Risk Index(GNRI) with 28-day mortality in critically very elderly patients and compare these indexes with APACHE II and SAPS II scores. Methods: This study is a observational and retrospective study. A total of 189 patients aged 85 years and older who were followed up in the intensive care unit between 2017 and 2021 were included in the study. Demographic data of the patients included in the study, length of stay in the intensive care unit, comorbidities, laboratory data of hospitalization in the intensive care unit, neutrophil/lymphocyte ratios, thrombocyte/lymphocyte ratios, APACHE II, SAPS II, PNI and GNRI index values of intensive care admissions were recorded. Results: In the statistical analysis performed for PNI and GNRI between Survival and Non-survival groups, a statistically significant difference was found between the groups (p=0.022 for PNI, p=0.010 for GNRI). The optimal threshold values of PNI and GNRI were 33.8 and 92.6, respectively. Sensitivity and specificity were 56.1% and 56.9% for PNI, 60.6% and 60.2% for the GNRI. Conclusion: The prognostic nutrition index and geriatric nutrition risk index are associated with 28-day mortality and malnutrition in very elderly patients treated in the intensive care unit. However, these scorings are not as sensitive and specific as APACHE II and SAPS II scores in predicting 28-day mortality.
Does prolonged prone position affect intracranial pressure? prospective observational study employing Optic nerve sheath diameter measurements
(2023-12-01) Demir U.; Taşkın Ö.; Yılmaz A.; Soylu V.G.; Doğanay Z.
Background: Our aim in this observational prospective study is to determine whether the prone position has an effect on intracranial pressure, by performing ultrasound-guided ONSD (Optic Nerve Sheath Diameter) measurements in patients with acute respiratory distress syndrome (ARDS) ventilated in the prone position. Methods: Patients hospitalized in the intensive care unit with a diagnosis of ARDS who were placed in the prone position for 24 h during their treatment were included in the study. Standardized sedation and neuromuscular blockade were applied to all patients in the prone position. Mechanical ventilation settings were standardized. Demographic data and patients’ pCO2, pO2, PaO2/FiO2, SpO2, right and left ONSD data, and complications were recorded at certain times over 24 h. Results: The evaluation of 24-hour prone-position data of patients with ARDS showed no significant increase in ONSD. There was no significant difference in pCO2 values either. PaO2/FiO2 and pO2 values demonstrated significant cumulative increases at all times. Post-prone SPO2 values at the 8th hour and later were significantly higher when compared to baseline (p < 0.001). Conclusion: As a result of this study, it appears that the prone position does not increase intracranial pressure during the first 24 h and can be safely utilized, given the administration of appropriate sedation, neuromuscular blockade, and mechanical ventilation strategy. ONSD measurements may increase the safety of monitoring in patients ventilated in the prone position.
Ferritin / albumin ratio could be a new indicator of COVID-19 disease mortality
(2023-01-01) Taşkin Ö.; Yilmaz A.; Soylu V.G.; Demir U.; Inan F.Ç.
Introductions: Despite significant advances in the management of patients with COVID-19, there is a need for markers to guide treatment and predict disease severity. In this study, we aimed to evaluate the relationship of the ferritin/albumin (FAR) ratio with disease mortality. Methodology: Acute Physiology and Chronic Health Assessment II scores and laboratory results of patients diagnosed with severe COVID-19 pneumonia were retrospectively analyzed. The patients were divided into two groups: survivors and non-survivors. Data for ferritin, albumin, and ferritin/albumin ratio among COVID-19 patients were analyzed and compared. Results: The mean age was higher in non-survivors (p = 0.778, p < 0.001, respectively). The ferritin/albumin ratio was significantly higher in the non-survival group (p < 0.05). Taking the cut-off value of the ferritin/albumin ratio of 128.71 in the ROC analysis, it predicted the critical clinical status of COVID-19 with 88.4% sensitivity and 88.4% specificity. Conclusions: ferritin/albumin ratio is a practical, inexpensive, and easily accessible test that can be used routinely. In our study, the ferritin/albumin ratio has been identified as a potential parameter in determining the mortality of critically ill COVID-19 patients treated in intensive care.
Study of bacteria isolated from COVID-19 and non-COVID-19 intensive care units and determination of their antibiotic susceptibility profiles
(2022-10-01) Kilinç Ç.; Çöplü N.; Yaşar Duman M.; Çalişir B.; Tüfekci E.F.; Gülhan M.; Yilmaz A.; Soylu V.G.
Nosocomial infections occur 48-72 hours after hospitalization, especially caused by bacteria, and pose a high risk for patients in intensive care units (ICUs), including COVID-ICUs. This study aimed to reveal bacteria distribution and antibiotic susceptibility profiles isolated from various clinical samples of non-COVID-ICU and COVID-ICU patients. We included in this study bacterial strains isolated from ICUs patients in Kastamonu Training and Research Hospital between March 2020 and October 2020. We identified the strains using the Vitek 2 compact automated system (BioMerieux, France) and standard microbiological methods. Using the Vitek 2 automated system, we analyzed antibiotic susceptibility tests and interpreted the results based on the European Committee for Antimicrobial Susceptibility Tests (EUCAST) guideline. There were 302 patients in the non-COVID-ICUs and 440 patients in the COVID-ICUs. We isolated a total of 470 strains, 370 from non-COVID-ICUs and 100 from COVID-ICUs. Acinetobacter spp. was the most frequently isolated strains for both ICUs. Acinetobacter spp. isolated from non-COVID-ICUs had higher resistance rates to meropenem (p= 0.043), ceftazidime (p= 0.014), and levofloxacin (p<0.001) antibiotics than strains from COVID-ICUs. Antibiotic susceptibility profiles of other strains were similar for both ICUs. As a result, the incidence of nosocomial infections in COVID-ICU patients was lower than in non-COVID-ICU patients. Health personnel working in COVID-ICUs may have played an important role in this, as they were more careful about using personal protective equipment and complying with hygiene rules. However, antibiotic resistance continues to be a serious problem in ICUs, including COVID-ICUs.