Browsing by Author "Kilic E."

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    Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: Risk factors for mortality
    (2013) Cilli 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 A.A.; 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 H.
    Purpose: 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. © 2013 Elsevier Inc.
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    Mortality indicators in community-acquired pneumonia requiring intensive care in Turkey
    (2013) Erdem H.; Turkan H.; Cilli A.; Karakas A.; Karakurt Z.; Bilge U.; Yazicioglu-Mocin O.; Elaldi N.; Adiguzel N.; Gungor G.; Taşci C.; Yilmaz G.; Oncul O.; Dogan-Celik A.; Erdemli O.; Oztoprak N.; Tomak Y.; Inan A.; Karaboǧa B.; Tok D.; Temur S.; Oksuz H.; Senturk O.; Buyukkocak U.; Yilmaz-Karadag F.; Ozcengiz D.; Turker T.; Afyon M.; Samur A.A.; Ulcay A.; Savasci U.; Diktas H.; Ozgen-Alpaydin A.; Kilic E.; Bilgic H.; Leblebicioglu H.; Unal S.; Sonmez G.; Gorenek L.
    Background: 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. © 2013 International Society for Infectious Diseases.
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    Discriminant validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis: A cohort study
    (Springer Verlag, 2015) Kilic E.; Kilic G.; Akgul O.; Ozgocmen S.
    The aim of this study was to assess discriminant validity of Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) and to compare with The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) as clinical tools for the measurement of disease activity in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). Also, the cut-off values for ASDAS-CRP in nr-axSpA and AS is revisited. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and were assessed for disease activity, quality of life and functional measures. The discriminatory ability of ASDAS-CRP and ASDAS-ESR was assessed using standardized mean differences and receiver operating characteristic (ROC) curves analysis. Optimal cut-off values for disease activity scores were calculated. Two hundred and eighty-seven patients with axSpA (nr-axSpA:132, AS:155) were included in this study. Two ASDAS versions and BASDAI had good correlations with patient’s and physician’s global assessment in both groups. Discriminatory ability of ASDAS-CRP, ASDAS-ESR and BASDAI were similar in patients with nr-axSpA and AS when the patients were assigned into low and high disease activity according to the ASAS partial remission, patient’s and physician’s global assessment scores (based on the comparison of ROC curves). ASDAS cut-off values are quite similar between groups indicating that ASDAS-CRP works similarly well in nr-axSpA and AS. The performance of ASDAS to discriminate low and high disease activity and cut-off values are quite similar in patients with AS and non-radiographic axial SpA. © 2014, Springer-Verlag Berlin Heidelberg.
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    Presence of enthesopathy demonstrated with ultrasonography in systemic sclerosis
    (Taylor and Francis Ltd, 2015) Kilic E.; Kilic G.; Akgul O.; Ozgocmen S.
    Objective. The aim of this study was to sonographically assess the presence and distribution of enthesopathy in systemic sclerosis (SSc). Methods. Consecutive patients with SSc and age-matched healthy controls were included in this study. All of the patients met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for SSc. Six entheses sites were evaluated using gray scale and Doppler ultrasonographies (USs) with a linear transducer and were scored using the Madrid Sonography Enthesitis Index (MASEI). Results. We evaluated 52 patients with SSc (46.10 ± 13.42 years) and 41 healthy controls (49.59 ± 9.35 years). Patients with SSc had significantly higher MASEI scores than the healthy controls. Except for plantar aponeurosis, the tendons and ligaments were thicker in the SSc group. In the SSc group, there were 25 (48.1%) diffuse cutaneous SScs and 22 (42.3%) limited cutaneous SScs. Variables such as age, BMI, disease duration, diagnostic delay and MASEI scores were similar in subgroups of SSc. There was a positive correlation between MASEI score and age, modified Rodnan's skin score and dyspnea grade, and a negative correlation with handgrip strength. Conclusion. To the best of our knowledge, this is the first study showing the presence of enthesopathy in patients with SSc using US. Enthesopathy should be kept in mind in symptomatic patients with SSc; additionally, it can be easily identified with US. © 2015 Japan College of Rheumatology.
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    Nationwide prospective audit for the evaluation of appendicitis risk prediction models in adults: Right iliac fossa treatment (RIFT) - Turkey
    (Oxford University Press, 2024) Yalcinkaya A.; Yalcinkaya A.; Balci B.; Keskin C.; Erkan I.; Yildiz A.; Kamer E.; Leventoglu S.; Caglikulekci M.; Zarbaliyev E.; Sevmis M.; Ulgen Y.; Altinel Y.; Meric S.; Akbas A.; Hacim N.A.; Vartanoglu Aktokmanyan T.; Aktimur Y.E.; Calikoglu F.; Gullu H.F.; Durma A.G.; Acar S.; Ciftci E.; Balik E.; Kulle C.B.; Ozata I.H.; Tufekci T.; Tatar C.; Sevinc M.M.; Sevik H.; Ertürk C.; Kiraz I.N.; Ozben V.; Aytac E.; Aliyeva Z.; Mutlu A.U.; Tanal M.; Celayir M.F.; Bozkurt E.; Yetkin S.G.; Ergin E.; Attaallah W.; Uprak T.K.; Omak A.; Simsek O.; Bozkurt M.A.; Kara Y.; Bozdag E.; Yirgin H.; Ozcan A.; Okkabaz N.; Ozdenkaya Y.; Haksal M.C.; Pekuz C.K.; Duru S.; Sivrikoz E.; Ozdemir Y.; Tan N.; Yarbug Karayali F.; Taghiyeva A.; Tirnova I.; Erenler Bayraktar I.; Bayraktar O.; Emsal E.Z.; Dalkilic M.I.; Yesiltas M.; Tok H.; Karakas D.O.; Pusane A.; Demirer A.I.; Sahin H.B.; Gok A.F.K.; Bozkurt H.A.; Yildirim M.; Uzunyolcu G.; Yanar H.T.; Ergun S.; Kutluk F.; Uludag S.S.; Zengin A.K.; Ozcelik M.F.; Sanli A.N.; Altuntas Y.E.; Memisoglu E.; Sari R.; Akdogan O.; Kucuk H.F.; Ozkan O.F.; Ulgur H.S.; Kirkan E.F.; Yuksekdag S.; Rencuzogullari A.; Aktas M.K.; Aba M.; Demirel A.O.; Eray I.C.; Aydogan B.; Cetinkunar S.; Yener K.; Sozutek A.; Irkorucu O.; Bayrak M.; Altintas Y.; Alabaz O.; Atasever A.; Erdogrul G.; Kupeli A.H.; Muhammedoglu B.; Kokdas S.; Kaya M.; Uysal E.; Yildirim A.C.; Zeren S.; Ekici M.F.; Algin M.C.; Kucuk G.O.; Eraslan H.; Aybar E.; Polat S.; Ceylan A.; Isik O.; Kural S.; Aktas A.; Bakar B.; Uzunoglu M.Y.; Gulcu B.; Ozturk E.; Devay A.O.; Taspinar E.; Balcin O.; Aksoy F.; Garip G.; Yalkin O.; Iflazoglu N.; Yigit D.; Kaya R.B.; Ugur M.; Kilic E.; Dedemoglu A.; Arslan R.E.; Temiz M.; Aydin C.; Demirli Atici S.; Kaya T.; Ozturk S.; Calik B.; Kilinc G.; Acar T.; Acar N.; Cengiz F.; Ureyen O.; Tan S.; Ilhan E.; Turk Y.; Durak A.T.; Yilmaz M.; Mercan M.; Atci R.; Sokmen S.; Bisgin T.; Egeli T.; Yildirim Y.; Safak T.; Celik K.; Yilmaz E.M.; Kirnap M.; Demirkiran A.E.; Sekerci U.U.; Karacan E.; Bilgic E.; Ozmen M.M.; Guldogan C.E.; Gundogdu E.; Moran M.; Erol T.; Dincer H.A.; Kirimtay B.; Yilmaz S.; Cennet O.; Yildiz A.; Sahin C.; Akyol C.; Koc M.A.; Ersoz S.; Turhan A.; Konca C.; Tezcaner T.; Erkent M.; Aydin O.; Avci T.; Altiner S.; Osmanov I.; Emral A.C.; Cetinkaya G.; Lapsekili E.; Sakca M.; Cimen S.; Ozen D.; Kozan E.B.; Dogan L.; Haberal E.; Kayhan O.; Aksel B.; Karabacak H.; Azili C.; Yazici F.; Apaydin M.; Kaya I.O.; Cetinkaya E.; Akin T.; Gunes G.; Turap H.; Aslan D.; Demirbag A.E.; Bolukbasi B.; Karaca B.E.; Ozturk E.; Ozeller E.; Kayacan G.S.; Borcek A.O.; Ece I.; Yormaz S.; Colak B.; Calisir A.; Sahin M.; Arslan K.; Hasirci I.; Ulutas M.E.; Metin S.H.; Gultekin F.A.; Ozkan Z.; Ilhan O.; Gundogdu T.; Liman R.K.; Kanat B.H.; Aydin A.; Sungurtekin U.; Ozgen U.; Aykota M.R.; Altintoprak F.; Gonullu E.; Cakmak G.; Dulger U.C.; Mantoglu B.; Demir H.; Akin E.; Eroz E.; Nazli O.; Dere O.; Dadasoglu M.A.; Kara E.; Tutcu S.; Solak I.; Gencer I.; Dalkiran A.; Sevinc B.; Karahan O.; Damburaci N.; Sari E.; Akay T.; Calta A.F.; Ozdemir A.; Ohri N.; Ermis I.; Bozbiyik O.; Ozdemir M.; Goktepe B.; Demir B.; Kilincarslan O.; Gunduz U.R.; Olcum M.; Dincer O.I.; Cakir R.C.; Dinc B.; Sahin E.; Uludag E.; Arslan Y.; Posteki G.; Oktay A.; Tatar O.C.; Guler S.A.; Utkan N.Z.; Tayar S.; Copelci Y.; Kartal M.; Kalayci T.; Yeni M.; Buyukkasap A.C.; Vural S.; Kesicioglu T.; Aydin I.; Gulmez M.; Saracoglu C.; Topcu O.; Kurt A.; Soylu S.; Kurt B.; Serin M.; Basceken S.I.; Gundes E.; Savda M.; Balkan A.Z.A.; Yildiz M.N.; Uzunkoy A.; Karaca E.; Berkan A.; Isik A.; Yildiz Y.A.; Ergul Z.; Yasar N.F.; Badak B.; Ozen A.; Velipasaoglu M.; Ure I.
    Background: Appendicitis is the most prevalent surgical emergency. The negative appendicectomy rate and diagnostic uncertainty are important concerns. This study aimed to assess the effectiveness of current appendicitis risk prediction models in patients with acute right iliac fossa pain. Methods: A nationwide prospective observational study was conducted, including all consecutive adult patients who presented with right iliac fossa pain. Diagnostic, clinical and negative appendicectomy rate data were recorded. The Alvarado score, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Adult Appendicitis Score systems were calculated with collected data to classify patients into risk categories. Diagnostic value and categorization performance were evaluated, with use of risk category-based metrics including 'true positive rate' (percentage of appendicitis patients in the highest risk category), 'failure rate' (percentage of patients with appendicitis in the lowest risk category) and 'categorization resolution' (true positive rate/failure rate). Results: A total of 3358 patients from 84 centres were included. Female patients were less likely to undergo surgery than men (71.5% versus 82.5% respectively; relative risk 0.866, 95% c.i. 0.834 to 0.901, P < 0.001); with a three-fold higher negative appendicectomy rate (11.3% versus 4.1% respectively; relative risk 2.744, 95% c.i. 2.047 to 3.677, P < 0.001). Ultrasonography was utilized in 56.8% and computed tomography in 75.2% of all patients. The Adult Appendicitis Score had the best diagnostic performance for the whole population; however, only RIPASA was significant in men. All scoring systems were successful in females patients, but Adult Appendicitis Score had the highest area under the receiver operating characteristic curve value. The RIPASA and the Adult Appendicitis Score had the best categorization resolution values, complemented by their exceedingly low failure rates in both male and female patients. Alvarado and AIR had extremely high failure rates in men. Conclusion: The negative appendicectomy rate was low overall, but women had an almost three-fold higher negative appendicectomy rate despite lower likelihood to undergo surgery. The overuse of imaging tests, best exemplified by the 75.2% frequency of patients undergoing computed tomography, may lead to increased costs. Risk-scoring systems such as RIPASA and Adult Appendicitis Score appear to be superior to Alvarado and AIR. © 2024 The Author(s). Published by Oxford University Press on behalf of BJS Foundation Ltd.