Browsing by Author "Kilinc, O"

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    Comparison of treatment outcomes in community-acquired pneumonia patients treated with beta lactam-macrolide combination versus fluoroquinolone monotherapy
    Kilinc, O; Soylar, O; Cilli, A; Sakar, A; Tasbakan, S; Ellidokuz, H; Celenk, B; Cetinkaya, C; Gunduz, C; Sayiner, A
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    Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation
    Cetinoglu, ED; Uzaslan, E; Sayiner, A; Cilli, A; Kilinc, O; Coskun, AS; Hazar, A; Kokturk, N; Filiz, A; Polatli, M
    Background: 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.
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    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, F
    Objective 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.
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    Comparison Of Four Different Empirical Antibiotic Treatment Regimen For Patients Hospitalized With Community-Acquired Pneumonia
    Cilli, 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, E
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    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, F
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    Effect of inhaled steroid therapy on treatment response in hosptalized pneumonia patients: Results from Turkish Thoracic Society database
    Baha, 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
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    Kokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Yuce, ZT; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Sakar, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
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    What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?
    Musellim, B; Borekci, S; Uzan, G; Sak, ZHA; Ozdemir, SK; Altinisik, G; Altunbey, SA; Sen, N; Kilinc, O; Yorgancioglu, A; Yilmaz, N; Ulasli, SS; Salepci, B; Ocakli, B; Sokullu, ZGE; Uzun, O; Kurtulus, S; Uslu, S; Saritas, E; Genc, S; Annakkaya, AN; Aydin, O; Bilgin, C; Turk, M; Ozmen, I; Tasbakan, MS; Halis, AN; Bahcecioglu, SN; Dabak, G; Isik, SR; Ozturk, AB; Akgun, M; Pihtili, A; Ozkan, G; Balbay, EG; Okumus, G; Onen, ZP; Yasayancan, N; Uysal, FE; Hanta, I; Kaya, Z; Turker, H; Berkesoglu, C; Celik, P; Cetinkaya, PD; Gundogus, B; Ongen, G; Tuncay, E; Erboy, F
    INTRODUCTION: Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff. OBJECTIVE: This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice. METHODS: A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study. The researchers were asked to examine patients in an almost ideal manner, without time constraint under available conditions. RESULTS: A total of 1680 patient examinations were reviewed. The mean duration of patient examination in ideal conditions was determined to be 20.4 +/- 9.6 min. Among all steps of patient examination, the longest time was spent for taking medical history. The total time spent for patient examination was statistically significantly longer in the university hospitals than in the governmental hospitals and training and research hospitals (P < 0.001). Among different patient categories, the patients with a chronic disorder presenting for the first time and were referred from primary or secondary to tertiary care for further evaluation have required the longest time for patient examination. CONCLUSION: According to our study, the appropriate minimal duration for patient examination is 20 min. It has been observed that in university hospitals and in patients with chronic pulmonary diseases, this duration has been increased to above 25 min. The durations in clinical practice should be planned accordingly.
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    Kokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, AS; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
    The COVID-19-related death rate varies between countries and is affected by various risk factors. This multi-center registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5-5.6). The univariate analysis demonstrated that various factors, including male sex, age >= 65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6-23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.
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    COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission
    Toprak, OB; Akpolat, T; Uzun, O; Deniz, PP; Kokturk, N; Varol, A; Guzel, E; Ercelik, M; Gultekin, O; Guner, R; Turan, S; Bekta, SG; Coskun, N; Bakan, N; Yakar, MN; Kutsoylu, OE; Ergan, B; Baris, SA; Basyigit, I; Boyaci, H; Cetinkaya, F; Colak, H; Aykac, N; Ketencioglu, BB; Yüce, ZT; Isik, SA; Yilmaz, ES; Karaoglanoglu, S; Safgi, SB; Ozkan, G; Kose, N; Kizilirmak, D; Havlucu, Y; Nural, S; Kerget, F; Sunal, O; Yuksel, A; Dursun, ZB; Deveci, F; Kuluozturk, M; Ataoglu, O; Dursun, M; Keskin, S; Sezgin, ME; Sezgin, ENA; Eser, F; Akyildiz, L; Almaz, MS; Kayaaslan, B; Hasanoglu, I; Bayrak, M; Gümüs, A; Sagcan, G; Cuhadaroglu, C; Kucuk, H; Onyilmaz, T; Mete, B; Kilinc, O; Itil, BO
    OBJECTIVE: As the pandem-ic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to as-sess hospitalized patients' vaccination status and document the efficacy of boosters.PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 pa-tients from collaborating centers were random-ly enrolled to understand/estimate the distri-bution of vaccination status in hospitalized pa-tients and to compare the efficacy of vaccina-tion/booster protocols.RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 dos-es, and 3.26-fold in those who received 4 doses.CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disad-vantaged.
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    The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort
    Babayigit, C; Kokturk, N; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
    Background and objectivesAlthough several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. MethodsPatients admitted to 26 different hospitals located in 16 different provinces between March 11-July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. ResultsWe retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 +/- 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5-12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (beta [95% CI]: 4.71 [2.31-7.11]; p = 0.001), favipiravir (beta [95% CI]: 3.55 [2.56-4.55]; p = 0.001) and HCQ (beta [95% CI]: 0.84 [0.02-1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70-5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28-6.75]; p = 0.011). ConclusionOur findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.
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    COVID-19: vaccination vs. hospitalization
    Uzun, O; Akpolat, T; Varol, A; Turan, S; Bektas, SG; Cetinkaya, PD; Dursun, M; Bakan, N; Ketencioglu, BB; Bayrak, M; Baris, SA; Guner, R; Gunal, O; Nural, S; Deniz, PP; Toprak, OB; Ozkan, G; Gumus, A; Kerget, F; Ercelik, M; Ataoglu, O; Yuksel, A; Ates, G; Kutsoylu, OE; Kose, N; Kizilirmak, D; Keskin, S; Gultekin, O; Coskun, N; Yilmaz, ES; Uslu, S; Basyigit, I; Ergan, B; Deveci, F; Yakar, MN; Zuhur, C; Sagcan, G; Yuce, ZT; Kuluozturk, M; Sezgin, ME; Sezgin, ENA; Havlucu, Y; Cuhadaroglu, C; Kilinc, O; Boyaci, H; Altunay, H; Akti, M; Dursun, ZB; Kalem, AK; Isik, SA; Akyildiz, L; Aykac, N; Almaz, MS; Kokturk, N; Itil, O
    Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.