Browsing by Author "Dikmen, O"

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    Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia
    Golcuk, Y; Golcuk, B; Bilge, A; Irik, M; Dikmen, O
    Objective: This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, >65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP). Methods: This prospective, observational, single-center, and cross-sectional study was conducted at emergency department (ED) between September 1, 2013, and July 31, 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results: A total of 174 patients (mean age, 66.7 +/- 15.8 years; 66.1% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 16.1%. A significant and inverse correlation between MPV and CURB-65 score was found (R = -.58, P < .001). We determined that the optimal MPV cutoff for predicting 28-day mortality at the time of ED admission was 8.55 fL, with a 75.0% sensitivity and a 75.3% specificity. For the prediction of 28-day mortality, the area under the receiver operating characteristic curve was 0.819 (95% confidence interval [CI], 0.740-0.898; P < .001) when the CURB-65 score was used alone, whereas it increased to 0.895 (95% CI, 0.819-0.936; P < .001) with the addition of MPV to the score. Conclusions: Mean platelet volume level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Furthermore, a combination of CURB-65 score and MPV can enhance the predictive accuracy of 28-day mortality. (C) 2015 Elsevier Inc. All rights reserved.
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    PREDICTING THE 28-DAY MORTALITY RATE IN ELDERLY PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: EVALUATION OF 11 RISK PREDICTION SCORES
    Elbi, H; Bilge, A; Dayangaç, HI; Dikmen, O
    Introduction: Community-acquired pneumonia frequently causes infectious disease-related morbidity and mortality among patients. Elderly patients are at a higher risk of developing severe Community-acquired pneumonia due to underlying diseases and changes in health status. We evaluated the performance of existing risk scores for predicting the 28-day mortality rate in elderly patients presenting with Community-acquired pneumonia to Emergency Department. Materials and Method: We evaluated 151 elderly patients [mean age, 76.6 +/- 7.8 years (range, 65-94 years); 65.6% men] with Community-acquired pneumonia. There were 30 deaths by day 28, with an all-cause mortality rate of 19.9%. All scores, except the CAP-PIRO, achieved an area under the receiver operating characteristic curve >0.700. Z-test was used to determine significant differences between the scores. Results: We evaluated 151 elderly patients [mean age, 76.6 +/- 7.8 years (range, 65-94 years); 65.6% men] with Community-acquired pneumonia. There were 30 deaths by day 28, with an all-cause mortality rate of 19.9%. All scores, except the CAP-PIRO, achieved an area under the receiver operating characteristic curve >0.700. Z-test was used to determine significant differences between the scores. Conclusion: Of the existing scores, 4 had good discriminatory power to predict the 28-day mortality rate. The best discrimination was demonstrated by CURB-age, a score designed for elderly patients with Community-acquired pneumonia. Additional research is necessary to determine the best risk score for predicting early mortality rates in elderly patients with Community-acquired pneumonia.