Browsing by Author "Hazar, A"
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Item Factors affecting treatment success in community acquired pneumonia (CAP)Gündüz, C; Tasbakan, MS; Sayiner, A; Çilli, A; Karaboga, B; Kilinç, O; Kiliç, Ö; Coskun, AS; Çetinkaya, C; Hazar, A; Tokgöz, FItem A new scoring system to predict mortality in community-acquired pneumonia: CURB (S)-65Bahçecioglu, SN; Köktürk, N; Baha, A; Yapar, D; Aksakal, FNB; Gunduz, C; Tasbakan, S; Sayiner, A; Coskun, AS; Yaman, F; Çilli, A; Celenk, B; Kilinç, O; Mersin, SS; Hazar, A; Tokgoz, FOBJECTIVE: The first decision to be made in the case of community-acquired pneumonia (CAP) is whether hospitalization of the patient is mandatory. In this study, we aimed to investigate whether the addition of oxygenation parameters to CURB-65 has diagnostic value in predicting mortality in CAP. PATIENTS AND METHODS: A total of 903 CAP patients were included in the study. Patients with a CURB-65 score of 0 and 1 were classified as Group 1 and patients with a CURB-65 score of 2 or more were classified as Group 2. The prediction of mortality through Pneumonia Severity Index (PSI), CURB-65 and CURBS-65/CURBP- 65 with the addition of SaO(2) and PaO2 values; hence the four different models, was compared among all patient groups. RESULTS: As a result, 3.3% of the cases in Group 1 and 12.7% of the cases in Group 2 died. In both CURB-65 groups, it was noted that the frequency of patients with SaO(2) <90% was significantly higher in the dead group than in the alive patient group (p= 0.009 and p= 0.001, respectively). In the univariate analysis, PaO2<60, and SaO(2)<90 were significantly associated with mortality. Model 2 (CURBS-65) and Model 3 (CURBP-65) were examined, SaO(2)< 90 (OR 2.08) was found to have an effect on death. In predicting mortality by the receiver operating characteristics (ROC) analysis, it was understood that the CURBS-65 score had a slightly higher area under the curve (AUC) value than CURB-65. CONCLUSIONS: As a result, it has been shown that the use of CURBS-65 scoring instead of CURB-65 clinical scoring may be more useful in predicting mortality.Item Effects of vaccination on clinical presentation of community acquired pneumonia (CAP)Çetinoglu, ED; Uzaslan, E; Çilli, A; Kilinç, O; Coskun, AS; Sayiner, A; Hazar, A; Kokturk, N; Filiz, A; Polatli, MItem 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 Antibiotic treatment outcomes in community-acquired pneumoniaÇilli, A; Sayiner, A; Çelenk, B; Sakar Coskun, A; Kilinç, O; Hazar, A; Aktas Samur, A; Tasbakan, S; Waterer, GW; Havlucu, Y; Kiliç, Ö; Tokgöz, F; Bilge, UBackground/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community-acquired pneumonia in nonintensive care unit (ICU) wards and treated with a beta-lactam, beta-lactam and macrolide combination, or a fluoroquinolone. Materials and methods: This prospective cohort study was perfbrined using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with beta-lactam, beta-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups. Conclusion: In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between beta-lactam, beta-lactam and macrolide combination, and fluoroquinolone regimens.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 Factors affecting short and long-term mortality after community-acquired pneumoniaAkyil, FT; Hazar, A; Yalçinsoy, M; Çilli, A; Çelenk, B; Kilinç, O; Kilinç, Ö; Sayiner, A; Tasbakan, S; Köktürk, N; Coskun, AS; Havlucu, Y; Filiz, A; Edis, EÇItem 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, F