Browsing by Author "Kendirli, T"

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    Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study)
    Yilmaz, D; Keles, YE; Emiroglu, M; Duramaz, BB; Ugur, C; Kocabas, BA; Celik, T; Ozdemir, H; Bayturan, S; Turel, O; Erdeniz, EH; Cakici, O; Taskin, EC; Erbas, IC; Genceli, M; Sari, EE; Caymaz, C; Kizil, MC; Sutcu, M; Demirbuga, A; Alkan, G; Bagci, Z; Dayar, GT; Ozkan, EA; Yilmaz, AT; Akca, M; Yesil, E; Kara, SS; Akturk, H; Yasar, B; Umit, Z; Uygun, H; Erdem, N; Buyukcam, A; Oncel, EK; Oz, SKT; Cetin, HS; Anil, AB; Yilmaz, R; Zengin, N; Uzuner, S; Albayrak, H; Borakay, O; Topal, S; Arslan, G; Yazar, A; Ozer, A; Kendirli, T; Kara, EM; Demirkol, D; Battal, F; Kosker, M; Akcan, OM; Kihtir, HS; Gul, D; Zararci, K; Alakaya, M; Kula, N; Celik, E; Petmezci, E; Evren, G; Aksay, AK; Konca, C; Sert, A; Arslan, D; Bornaun, H; Tekeli, O; Bal, A; Sahin, IO; Demir, S; Sap, F; Akyol, MB; Tanidir, IC; Donmez, YN; Ucar, T; Coban, S; Arga, G; Torun, SH; Karpuz, D; Celik, SF; Varan, C; Elmali, F; Oncel, S; Belet, N; Hatipoglu, N; Karabulut, ND; Turgut, M; Somer, A; Kuyucu, N; Dinleyici, EC; Ciftci, E; Kara, A
    Purpose Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU).Methods This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented.Results A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5-11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells x mu L, platelet count 153 vs. 212 cells x 10(3)/ mu L, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 mu g/L, ferritin 644 vs. 334 mu g/L, all for p< 0.001). Being between ages 5-12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971-8.627] and six times (95% CI 2.575-14.654), respectively, compared to being between the ages 0-5. A one-unit increase in log d-dimer (mu g/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079-3.233) and 1.4 times (95% CI 1.133-1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care.
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    Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study
    Sik, G; Inamlik, A; Akçay, N; Kesici, S; Aygun, F; Kendirli, T; Atay, G; Sandal, O; Varol, F; Ozkaya, PY; Duyu, M; Birbilen, AZ; Ozcan, S; Arslan, G; Kangin, M; Bayraktar, S; Altug, U; Anil, AB; Havan, M; Yetimakman, AF; Dalkiran, T; Zengin, N; Oto, A; Kihtir, HS; Girgin, FI; Telhan, L; Yildizdas, D; Yener, N; Yukselmis, U; Alakaya, M; Kilinc, MA; Celegen, M; Dursun, A; Battal, F; Sari, F; Ozkale, M; Topal, S; Kocaoglu, C; Yazar, A; Alacakir, N; Odek, C; Yaman, A; Citak, A
    BackgroundThis study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit.MethodsA retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome.ResultsThe organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation.ConclusionsIn cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality.ImpactMIS-C is a life-threatening condition.Patients need to be followed up in the intensive care unit.Early detection of factors associated with mortality can improve outcomes.Determining the factors associated with mortality and length of stay will help clinicians in patient management.High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients.We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality.