Browsing by Author "Duman, S"

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    Frontal QRS/T angle can predict mortality in COVID-19 patients
    Gunduz, R; Yildiz, BS; Ozgur, S; Ozen, MB; Bakir, EO; Ozdemir, IH; Cetin, N; Usalp, S; Duman, S
    Aims: The frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and nonischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation.Methods and results: An electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90 degrees versus an fQRS angle <_90 degrees. The percentages of mortality and the need for mechanical ventilation according to fQRS angle were 67.8% and 66.1%, respectively, in the fQRs >90 degrees group and 26.1% and 29.9% in the fQRS <_90 degrees group. Heart rate, oxygen saturation, fQRS angle, estimated glomerular filtration rate, and C-reactive protein level were predictors of mortality on the multivariable analysis. The mortality risk increased 2.9-fold on the univariate analysis and 1.6-fold on the multivariate analysis for the fQRS >90 degrees patient group versus the fQRS <_90 degrees group.Conclusion: In conclusion, a wide fQRS angle >90 degrees was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients.(c) 2022 Elsevier Inc. All rights reserved.
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    Multi-Center Experience of Coronary Artery Perforation During Percutaneous Coronary Intervention: Clinical and Angiographic Characteristics, Management, and Outcomes Between 2010 and 2020
    Gündüz, R; Yildiz, BS; Çetin, N; Özgür, S; Çizgici, AY; Tülüce, K; Tülüce, SY; Özen, MB; Duman, S; Bayturan, O
    Background: Coronary artery perforations are one of the most feared, rare, and catastrophic complication of percutaneous coronary intervention. Despite the remarkable increase in coronary angiography and percutaneous coronary intervention, there is no large database that collects coronary artery perforation for the Turkish population. Our study aimed to report our experience over a 10-year period for clinical and angiographic characteristics, management strategies, and outcomes of coronary artery perforation during the percutaneous coronary intervention at different cardiology departments in Turkey. Methods: The study data came from a retrospective analysis of 48 360 percutaneous coronary intervention procedures between January 2010 and June 2020. A total of 110 cases who had coronary artery perforation during the percutaneous coronary intervention were found by angiographic review. Analysis has been performed for the basic clinical, angiographic, procedural characteristics, the management of coronary artery perforation, and outcome of all patients. Results: The coronary artery perforation rate was 0.22%. Out of 110 patients with coronary artery perforation, 66 patients showed indications for percutaneous coronary intervention with acute coronary syndrome and 44 patients with stable angina pectoris. The most common lesion type and perforated artery were type C (34.5%) and left anterior descending (41.8%), respectively. The most observed coronary artery perforation according to Ellis classification was type III (37.2%). Almost 52.7% of patients have a covered stent implanted in the perforated artery. The all-cause mortality rate of coronary artery perforation patients in the hospital was 18.1%. Conclusion: The observed rate of coronary artery perforation in our study is consistent with the studies in this literature. However, the mortality rates related to coronary artery perforation are higher than in other studies in this literature. Especially, the in-hospital mortality rate was higher in type II and type III groups due to perforation and its complications. Nevertheless, percutaneous coronary intervention should be done in selected patients despite catastrophic complications.
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    Colistin and Acute Renal Failure: A Centre's Experience
    Hür, E; Çetinturk, A; Eminoglu, V; Sungur, M; Tavsan, Ö; Piskinpasa, SV; Severcan, E; Karaca, N; Duman, S
    OBJECTIVE: Colistin is a polymyxin antibiotic with a polypeptide structure and is effective against gram-negative bacilli. Although its use had decreased due to its side effects, it has increased again in recent years, especially for multi-drug resistant Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter and Enterobacteriaceae. In the present study, patients that received colistin at one center were retrospectively analysed in terms of nephrotoxicity. MATERIAL and METHODS: Patients hospitalized and treated with colistin in the intensive care unit between January 2012 and August 2013 were analyzed. Demographic data; biochemical tests at baseline, daily during hospitalization and after discharge; and the initial, maintenance and total doses of colistin were evaluated. RESULTS: The mean age was 62 +/- 13 (31-86) years for the 27 patients with 17 (63%) males that were followed-up for an average duration of 63 +/- 89 days. During follow-up, 18 patients (66.7%) developed acute renal failure (ARF) and 17 (63%) of died. There were 12 (66.7%) mortalities in the ARF group and 5 (55%) in the group without ARF (p> 0.05). The total colistin dose and leukocyte count were higher in the ARF group with 3.75 +/- 2.34 g and 12.04 +/- 5.05/mm(3) than the non-ARF group at 3.32 +/- 1.86 g and 7.60 +/- 3.7/mm(3) but did not reach statistical significance. CONCLUSION: ARF increases the mortality in ICU patients. Although colistin is an effective therapeutic agent used for resistant infections, we have to avoid higher doses due to its potential side effect of ARF.