Browsing by Author "Sayiner A."
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Item Treatment of severe asthma: Expert opinion; [Aǧi{dotless}r asti{dotless}m tedavisi: Uzman görüşü](Ankara University, 2014) Türktaş H.; Bavbek S.; Çelik G.; Demir T.; Gemicioǧlu B.; Günen H.; Kiyan E.; Mungan D.; Oǧuzülgen I.K.; Polatli M.; Saryal S.; Sayiner A.; Şen E.; Yildirim N.; Yildiz F.; Yorgancioǧlu A.Severe asthmatics account 10% of the all asthmatic population. Those asthmatics whose disease is inadequately controlled account for up to half of the cost for asthma, because they have more emergency room visits, more hospital admission and greater absenteeism from work. New therapeutic options were tried in those patients whose asthma was uncontrolled with standart high dose inhaled corticosteroid and long acting beta-2 agonsit combination therapy. In this paper taking into account the conditions of our country, current literature was reviewed and treatment options was discussed and graded recommendations are made for daily clinical practice in patients with severe treatment-refractory asthma.Item Asthma-KOAH overlap syndrome; [Astım-KOAH overlap sendromu](Ankara University, 2015) Şen E.; Oğuzülgen K.; Bavbek S.; Günen H.; Kiyan E.; Türktaş H.; Yorgancioğlu A.; Polatli M.; Yildiz F.; Çelik G.; Demir T.; Gemicioğlu B.; Mungan D.; Saryal S.; Sayiner A.; Yildirim N.Asthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named “Asthma-COPD Overlap Syndrome” (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV1/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > %12 of FEV1 pred or increase of FEV1 > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines. © 2015, Ankara University. All rights reserved.Item Koah ve astımda atak; [KOAH ve astımda atak](Ankara University, 2015) Yildirim N.; Demir T.; Gemicioğlu B.; Kiyan E.; Oğuzülgen K.; Polatli M.; Saryal S.; Sayiner A.; Yorgancioğlu A.; Bavbek S.; Çelik G.E.; Günen H.; Mungan D.; Şen E.; Türktaş H.; Yildiz F.Chronic obstructive pulmonary disease (COPD) and asthma are airway diseases with acute exacerbations. Natural course of both disease are affected by exacerbations. COPD exacerbations may be caused by infections and other causes; indoor and outdoor pollution, cardiovascular diseases, asthma-COPD overlap syndrome, COPD- obstructive sleep apnea syndrome, pulmonary embolism, gastro-oesophageal reflux, anxiety-depression, pulmonary hypertension. Exposure to triggering factors, viral infections, treatment insufficiency may cause asthma exacerbations. Smoking cessations, prevention of infections, long-acting anticholinergics, long-acting β2 agonists, inhaled corticosteroids, phosphodiesterase-4 inhibitors, mucolytics, prophilactic antibiotics can be effective on the prevention of COPD exacerbations. Asthma exacerbations may be decreased by the avoidance of allergens, viral infections, occupational exposures, airpollution, treatment of comorbid diseases. Effective treatment of asthma is required to prevent asthma exacerbations. Inhaled steroids and combined treatments are the most effective preventive therapy for exacerbations. Patient education and cooperation is an element of the preventive measures for asthma attacks. Compliance to therapy, inhalation techniques, written asthma plans are required. The essential of COPD and asthma exacerbation treatment is bronchodilator therapy. Steroids are also implemented to the therapy, targeting the inflammation. Specific treatments of the cause (infection, airpollution, pulmonary embolism etc.) should be administered. © 2015, Ankara University. All rights reserved.Item Serum procalcitonin and C-reactive protein kinetics as indicators of treatment outcome in hospitalized patients with community-acquired pneumonia(Turkiye Klinikleri Journal of Medical Sciences, 2016) Taşbakan M.S.; Gündüz C.; Sayiner A.; Çilli A.; Çelenk Karaboğa B.; Şakar Çoşkun A.; Durmaz Yaman F.; Kilinç O.; Kiliç Soylar Ö.Background/aim: There has been growing interest in the use of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with community-acquired pneumonia (CAP). The aim of this study was to investigate whether an assessment of fever, leukocyte count, and serum CRP and PCT levels on admission and during follow-up (day 3) provides any information about the clinical outcome in hospitalized patients with CAP. Materials and methods: Patients with a diagnosis of CAP who were admitted to and followed at four university hospitals were evaluated retrospectively using the Turkish Thoracic Society Pneumonia Database. Results: A total of 103 hospitalized CAP patients (57 males, mean age: 61.5 ± 16.7 years) were enrolled in the study. Treatment failure (TF) was observed in 20 patients (19.4%). Pneumonia Severity Index scores, serum CRP levels, and PCT levels on admission were significantly higher in the TF group. There were significant decreases in CRP and PCT levels between admission day and day 3 in the treatment success group. Conclusion: In patients with CAP, the body temperature and leukocyte count on admission do not predict outcome. Monitoring levels of CRP and PCT may be useful as a predictor of treatment outcome. © TÜBİTAK.Item Clinical characteristics and outcome of healthcare associated pneumonia in Turkey; [Türkiye’de sağlık bakımı ile ilişkili pnömoni olgularının klinik özellikleri ve sonuçları](Ankara University, 2016) Gündüz C.; Taşbakan M.S.; Sayiner A.; Çıllı A.; Kilinç O.; Şakar Coşkun A.Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with communityacquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65.3 ± 16.4, 530 male) registered to Turkish Thoracic Society Respiratory Infections Study Group CAP database (TURCAP) were examined. The demographic data, clinical history, pneumonia severity scores (PSI), laboratory and radiologic findings of the CAP and HCAP patients were compared. Results: Out of 785 cases, 207 (26.4%) were diagnosed with HCAP and 578 (73.6%) with CAP. Among HCAP cases, 140/207 (67.6%) had preceding hospitalization in the last 90 days, 28/207 (13.5%) were on a hemodialysis program during the previous 30 days and 22/207 (10.6%) were staying in nursing homes. Patients with HCAP more frequently had comorbidities (93.2% vs. 81.6%; p= 0.001) and higher PSI scores (103.9 ± 37.2 vs. 94.6 ± 35.4; p= 0.002) compared to patients with CAP. A causative microorganism was isolated in only 12.1% (70/578) of CAP and 14.5% (30/207) of HCAP patients. The length of stay in hospital was higher in HCAP than CAP (8.6 ± 5.5 vs. 7.5 ± 6.1 days, p= 0.03); however the rates of treatment failure, intensive care unit admission and mortality were similar. Conclusion: In comparison to CAP, HCAP patients tend to have more severe disease, despite have no difference in mortality. The current criteria for HCAP do not predict worse clinical outcomes. Further work is required to define local risk factors for multidrug resistant pathogens. © 2016, Ankara University. All rights reserved.Item Factors affecting treatment success in community-acquired pneumonia(Turkiye Klinikleri Journal of Medical Sciences, 2016) Gündüz C.; Taşbakan M.S.; Sayiner A.; Çilli A.; Kilinç O.; Şakar Coşkun A.Background/aim: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. Materials and methods: A total of 537 patients (mean age: 66.1 ± 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. Results: Lower numbers of neutrophils (5989.9 ± 6237.3 vs. 8495.6 ± 7279.5/mm3), higher blood urea levels (66.1 ± 42.1 vs. 51.2 ± 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 ± 42.6 vs. 96.3 ± 32.9), higher CURB-65 scores (2.7 ± 1.2 vs. 2.2 ± 0.9), lower PaO2/FiO2 ratios (216.3 ± 86.8 vs. 269.9 ± 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO2 ratio were independent parameters affecting treatment results in multivariate linear regression analysis (P < 0.001). Conclusion: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases. © TÜBİTAK.Item Antibiotic treatment outcomes in community-acquired pneumonia(Turkiye Klinikleri Journal of Medical Sciences, 2018) Çilli A.; Sayiner A.; Çelenk B.; Şakar Coşkun A.; Kilinç O.; Hazar A.; Aktaş Samur A.; Taşbakan S.; Waterer G.W.; Havlucu Y.; Kiliç Ö.; Tokgöz F.; Bilge U.Background/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 β-lactam, β-lactam and macrolide combination, or a fluoroquinolone. Materials and methods: This prospective cohort study was performed 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 β-lactam, β-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 β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens. © TÜBİTAK.Item Prognosis of hospitalized patients with community-acquired pneumonia(Elsevier Doyma, 2018) Tokgoz Akyil F.; Yalcinsoy M.; Hazar A.; Cilli A.; Celenk B.; Kilic O.; Sayiner A.; Kokturk N.; Sakar Coskun A.; Filiz A.; Cakir Edis E.Introduction: 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. © 2017 Sociedade Portuguesa de PneumologiaItem The effect of inhaled corticosteroids in the outcomes of community-acquired pneumonia: ICCAP study (TURKCAP Database)(Blackwell Publishing Ltd, 2020) Baha A.; Kokturk N.; Bahcecioglu S.N.; Yapar D.; Aksakal N.; Gündüz C.; Tasbakan S.; Sayiner A.; Coskun A.S.; Durmaz F.; Cilli A.; Celenk B.; Kılınc 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. © 2020 John Wiley & Sons LtdItem The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients(W.B. Saunders Ltd, 2021) Kokturk N.; Babayigit C.; Kul S.; Duru Cetinkaya P.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter 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. © 2021 Elsevier LtdItem The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort(Frontiers Media S.A., 2022) Babayigit C.; Kokturk N.; Kul S.; Cetinkaya P.D.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.Background and objectives: Although 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. Methods: Patients 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. Results: We 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 (β [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (β [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (β [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). Conclusion: Our 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. Copyright © 2022 Babayigit, Kokturk, Kul, Cetinkaya, Atis Nayci, Argun Baris, Karcioglu, Aysert, Irmak, Akbas Yuksel, Sekibag, Baydar Toprak, Azak, Mulamahmutoglu, Cuhadaroglu, Demirel, Kerget, Baran Ketencioglu, Ozger, Ozkan, Ture, Ergan, Avkan Oguz, Kilinc, Ercelik, Ulukavak Ciftci, Alici, Nurlu Temel, Ataoglu, Aydin, Cetiner Bahcetepe, Gullu, Fakili, Deveci, Kose, Tor, Gunluoglu, Altin, Turgut, Tuna, Ozturk, Dikensoy, Yildiz Gulhan, Basyigit, Boyaci, Oguzulgen, Borekci, Gemicioglu, Bayraktar, Elbek, Hanta, Kuzu Okur, Sagcan, Uzun, Akgun, Altinisik, Dursun, Cakir Edis, Gulhan, Oner Eyuboglu, Gultekin, Havlucu, Ozkan, Sakar Coskun, Sayiner, Kalyoncu, Itil and Bayram.Item Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study; [Astım KOAH overlap: Ulusal çok merkezli bir çalışma sonuçları](Ankara University, 2024) Çelik G.E.; Aydin Ö.; Şen E.; Demir T.; Gemicioğlu B.; Kiyan E.; Mungan D.; Kivilcim Oğuzülgen İ.; Polatli M.; Göksel Ö.; Sayiner A.; Yildirim N.; Yildiz F.; Yorgancioğlu A.; Elhan A.H.; Yildiz Ö.; Başyiğit İ.; Börekçi Ş.; Havlucu Y.; Okumuş G.; Türk M.; Saryal S.Introduction: Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in Türkiye. Materials and Methods: The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups. Results: The study included 408 subjects (F/M= 205/203, mean age= 56.24 ± 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radio-logic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p< 0.001). The annual decline in FEV1 was more prominent in the ACO group (mean=-250 mL) than in the asthma (mean change=-60 mL) and COPD (mean change=-230 mL) groups (p= 0.003). Conclusion: This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the abovementioned symptoms. © 2024 by Tuberculosis and Thorax.