Browsing by Author "Taşbakan M.S."

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    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.
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    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.
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    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.