Browsing by Author "Cilli, A"
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Item Comparison of treatment outcomes in community-acquired pneumonia patients treated with beta lactam-macrolide combination versus fluoroquinolone monotherapyKilinc, O; Soylar, O; Cilli, A; Sakar, A; Tasbakan, S; Ellidokuz, H; Celenk, B; Cetinkaya, C; Gunduz, C; Sayiner, AItem National safety data of post-marketing use of omalizumab in severe persistent asthma in TurkeyDursun, A; Bavbek, S; Misirligil, Z; Erdener, F; Buyukozturk, S; Aydin, O; Gemicioglu, B; Bayrak, P; Erkekol, FO; Yildirim, Z; Cilli, A; Boz, AB; Alpaydyn, AO; Karakoc, G; Gorguner, M; Karakaya, G; Isik, R; Sapan, N; Bakirtas, AItem Prognosis of hospitalized patients with community-acquired pneumoniaAkyil, FT; Yalcinsoy, M; Hazar, A; Cilli, A; Celenk, B; Kilic, O; Sayiner, A; Kokturk, N; Coskun, AS; Filiz, A; Edis, ECIntroduction: The long-term prognosis of patients with community-acquired pneumonia (CAP) has attracted increasing interest in recent years. The objective of the present study is to investigate the short and long-term outcomes in hospitalized patients with CAP and to identify the predictive factors associated with mortality. Patients and methods: The study was designed as a retrospective, multicenter, observational study. Hospitalized patients with CAP, as recorded in the pneumonia database of the Turkish Thoracic Society between 2011 and 2013, were included. Short-term mortality was defined as 30-day mortality and long-term mortality was assessed from those who survived 30 days. Predictive factors for short- and long-term mortality were analyzed. Results: The study included 785 patients, 68% of whom were male and the mean age was 67 +/- 16 (18-92). The median duration of follow-up was 61.2 +/- 11.8 (37-90) months. Thirty-day mortality was 9.2% and the median survival of patients surviving 30 days was 62.8 +/- 4.4 months. Multivariate analysis revealed that advanced age, the absence of fever, a higher Charlson comorbidity score, higher blood urea nitrogen (BUN)/albumin ratios and lower alanine aminotransferase (ALT) levels were all predictors of long-term mortality. Conclusion: Long-term mortality following hospitalization for CAP is high. Charlson score and lack of fever are potential indicators for decreased long-term survival. As novel parameters, baseline BUN/albumin ratios and ALT levels are significantly associated with late mortality. Further interventions and closer monitoring are necessary for such subgroups of patients. (C) 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U.Item Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentationCetinoglu, ED; Uzaslan, E; Sayiner, A; Cilli, A; Kilinc, O; Coskun, AS; Hazar, A; Kokturk, N; Filiz, A; Polatli, MBackground: Previous reports have shown that vaccination rates of adult at-risk populations are low in Turkey. There are differing reports with regards to the effectiveness of the influenza and the pneumococcal polysaccharide vaccine (PPSV23) on the clinical outcomes of community acquired pneumonia (CAP). The purpose of this study was to analyze the influenza (FV) and pneumococcal vaccination (PV) status, the factors that influence the receipt of influenza/pneumococcal vaccine and the effects of prior vaccination on the clinical outcomes in adults hospitalized with CAP. Patients and Methods: Patients hospitalized with CAP between March 2009 and October 2013 and registered at the web-based Turkish Thoracic Society Pneumonia Database (TURCAP) were included in this multicentric, observational study. Of a total of 787 cases, data were analyzed for 466 patients for whom self-reported information on PV and FV was available. Results: In this adult population with CAP, the vaccination rate with both the pneumococcal and influenza vaccines was found to be 6%. Prior FV was found to be the sole variable that was associated with the receipt of PV [OR 17.8, 95% CI (25-75:8.56-37.01), p < 0.001]. Conversely, being vaccinated with PPSV23 was the only predictor of receipt of FV [OR 18.1, 95% CI (25 - 75:8.75 - 37.83), p < 0.001]. Compared to the unvaccinated cases, the chest radiograms of the vaccinated patients revealed less consolidation. The latter also reported fatigue, muscle pain and gastrointestinal symptoms less frequently. Although there was a trend for lower 30-day mortality and for lower rates of intensive care unit (ICU) admission, these did not reach statistical significance. A pneumonia severity index (PSI) score >= 90, CURB-65 score >= 3 and multilobar involvement, but not the vaccination status, were identified as independent determinants of ICU admission. Conclusions: This study showed that, among patients hospitalized with CAP, the FV and/or PV rates are low. Prior vaccination does not appear to significantly affect the clinical outcomes.Item The effect of inhaled corticosteroids in the outcomes of community-acquired pneumonia: ICCAP study (TURKCAP Database)Baha, A; Kokturk, N; Bahcecioglu, SN; Yapar, D; Aksakal, N; Gündüz, C; Tasbakan, S; Sayiner, A; Coskun, AS; Durmaz, F; Cilli, A; Celenk, B; Kilinc, O; Salman, S; Hazar, A; Tokgoz, FObjective We aimed to investigate the effect of inhaled corticosteroids (ICS) in the outcomes of community-acquired pneumonia (CAP), as well as to determine if ICS usage is exist among the risk factors for mortality in those patients. Materials and Methods In this retrospective cross-sectional multicentre study, 1069 hospitalised CAP patients were investigated using CAP Database of Turkish Thoracic Society (TURKCAP Database). The patients were divided into two groups, depending on their ICS use. The data were analysed by appropriate statistical methods. Results 172 (75.8%) of the 227 patients who were on ICS had COPD and 37 (16.3%) had asthma. There were fewer patients with fever among ICS-users compared to non-ICS users (P = 0.013), and less muscle pain (P = 0.015) and fewer GIS symptoms (P = 0.022). No statistically significant difference was found between ICS use/ type of ICS and the duration of hospitalisation (P = 0.286). The multivariate regression analysis showed that patients using ICS had lower body temperature and, less crackles/bronchial sound. In the multivariate logistic regression model lung cancer (OR: 6.75), glucose (OR: 1.01) and CURB-65 (OR: 1.72) were significantly associated with mortality in the CAP patients. ICS usage were not found to be associated with mortality. Conclusion The use of ICS by the patients with CAP admitted to the hospital is not independently related with any radiological pattern, hospitalisation duration and mortality. ICS usage may diminish fever response and may suppress the findings of crackles and/or bronchial sounds. This needs further confirmation.Item Comparison Of Four Different Empirical Antibiotic Treatment Regimen For Patients Hospitalized With Community-Acquired PneumoniaCilli, A; Sakar, A; Kilinc, O; Sayiner, A; Hazar, A; Samur, A; Celenk, B; Havlucu, Y; Kilic, O; Tasbakan, S; Kokturk, N; Edis, E; Filiz, A; Uzarslan, EItem CURB 65 or CURB (S) 65 for Community-Acquired Pneumonia?Köktürk, N; Bahecioglu, SN; Baha, A; Gunduz, C; Tasbakan, S; Sayiner, A; Coskun, A; Durmaz, F; Cilli, A; Celenk, B; Kilinc, O; Salman, S; Hazar, A; Tokgoz, FItem Effect of inhaled steroid therapy on treatment response in hosptalized pneumonia patients: Results from Turkish Thoracic Society databaseBaha, A; Kokturk, N; Bahcecioglu, S; Gunduz, C; Tasbakan, S; Sayiner, A; Coskun, A; Durmaz, F; Cilli, A; Celenk, B; Kilinc, O; Salman, S; Hazar, A; Tokgoz, FItem The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective studyErdem, H; Kocak-Tufan, Z; Yilmaz, O; Karakurt, Z; Cilli, A; Turkan, H; Yazicioglu-Mocin, O; Adiguzel, N; Gungor, G; Tasci, C; Yilmaz, G; Oncul, O; Dogan-Celik, A; Erdemli, O; Oztoprak, N; Tomak, Y; Inan, A; Tok, D; Temur, S; Oksuz, H; Senturk, O; Buyukkocak, U; Yilmaz-Karadag, F; Ozturk-Engin, D; Ozcengiz, D; Karakas, A; Bilgic, H; Leblebicioglu, HBackground: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. Methods: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. Results: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. Conclusion: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series.Item Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: Risk factors for mortalityCilli, A; Erdem, H; Karakurt, Z; Turkan, H; Yazicioglu-Mocin, O; Adiguzel, N; Gungor, G; Bilge, U; Tasci, C; Yilmaz, G; Oncul, O; Dogan-Celik, A; Erdemli, O; Oztoprak, N; Samur, AA; Tomak, Y; Inan, A; Karaboga, B; Tok, D; Temur, S; Oksuz, H; Senturk, O; Buyukkocak, U; Yilmaz-Karadag, F; Ozcengiz, D; Karakas, A; Savasci, U; Ozgen-Alpaydin, A; Kilic, E; Elaldi, N; Bilgic, HPurpose: The aims of this study are to identify factors predicting mortality in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission and to examine whether noninvasive ventilation treatment reduces mortality. Materials and Methods: An analysis was performed on data from patients with CAP hospitalized in the ICUs of 19 different hospitals in Turkey between October 2008 and January 2011. Predictors of mortality were assessed by both univariate and multivariate statistical analyses. Results: Two hundred eleven patients with COPD and CAP were included. The overall ICU mortality was 23.9%. Noninvasive ventilation treatment (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.03-0.49; P=.003), hypertension (OR, 0.13; 95% CI, 0.02-0.93; P=.042), bilateral infiltration (OR, 13.92; 95% CI, 2.94-65.84; P=.001), systemic corticosteroid treatment (OR, 0.19; 95% CI, 0.35-0.96; P=.045), length of ICU stay (OR, 0.65; 95% CI, 0.47-0.89; P=.007), and duration of invasive mechanical ventilation (OR, 1.11; 95% CI, 1.01-1.22; P=.032) were independent factors related to mortality. Conclusion: Noninvasive ventilation, hypertension, systemic corticosteroid treatment, and shorter ICU stay are associated with reduced mortality, whereas bilateral infiltration and longer duration of invasive mechanical ventilation are associated with increased risk of mortality in patients with COPD and CAP requiring ICU admission. (C) 2013 Elsevier Inc. All rights reserved.Item Mortality indicators in community-acquired pneumonia requiring intensive care in TurkeyErdem, H; Turkan, H; Cilli, A; Karakas, A; Karakurt, Z; Bilge, U; Yazicioglu-Mocin, O; Elaldi, N; Adiguzel, N; Gungor, G; Tasci, C; Yilmaz, G; Oncul, O; Dogan-Celik, A; Erdemli, O; Oztoprak, N; Tomak, Y; Inan, A; Karaboga, B; Tok, D; Temur, S; Oksuz, H; Senturk, O; Buyukkocak, U; Yilmaz-Karadag, F; Ozcengiz, D; Turker, T; Afyon, M; Samur, AA; Ulcay, A; Savasci, U; Diktas, H; Ozgen-Alpaydin, A; Kilic, E; Bilgic, H; Leblebicioglu, H; Unal, S; Sonmez, G; Gorenek, LBackground: Severe community-acquired pneumonia (SCAP) is a fatal disease. This study was conducted to describe an outcome analysis of the intensive care units (ICUs) of Turkey. Methods: This study evaluated SCAP cases hospitalized in the ICUs of 19 different hospitals between October 2008 and January 2011. The cases of 413 patients admitted to the ICUs were retrospectively analyzed. Results: Overall 413 patients were included in the study and 129 (31.2%) died. It was found that bilateral pulmonary involvement (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.7) and CAP PIRO score (OR 2, 95% CI 1.3-2.9) were independent risk factors for a higher in-ICU mortality, while arterial hypertension (OR 0.3, 95% CI 0.1-0.9) and the application of non-invasive ventilation (OR 0.2, 95% CI 0.1-0.5) decreased mortality. No culture of any kind was obtained for 90 (22%) patients during the entire course of the hospitalization. Blood, bronchoalveolar lavage, and non-bronchoscopic lavage cultures yielded enteric Gram-negatives (n = 12), followed by Staphylococcus aureus (n = 10), pneumococci (n = 6), and Pseudomonas aeruginosa (n = 6). For 22% of the patients, none of the culture methods were applied. Conclusions: SCAP requiring ICU admission is associated with considerable mortality for ICU patients. Increased awareness appears essential for the microbiological diagnosis of this disease. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.