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Okşul M, Bilge Ö, Taştan E, Işık F, İnci Ü, Akın H, Söner S, Cömert AD, Tüzün R, Çap M, Şener YZ, Baysal E. Evaluation of the effect of bun/albumin ratio on in-hospital mortality in hypertensive COVID-19 patients. Eur Rev Med Pharmacol Sci 2023; 27:2127-2131. [PMID: 36930512 DOI: 10.26355/eurrev_202303_31584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The impact of COVID-19 infection still continues all over the world and is an important cause of mortality. The mortality rate due to infection varies between 1-5%. The mortality rate is higher in those with cardiovascular risk factors, especially in cases with hypertension. Some studies have shown that blood urea nitrogen (BUN) and albumin levels are associated with worse prognosis in patients with COVID-19. In our study, we aimed to investigate whether the BUN/albumin (BAR) ratio has an effect on in-hospital mortality in hypertensive COVID-19 patients. PATIENTS AND METHODS A total of 800 hypertensive COVID-19 patients, (618 of whom were alive and 182 died) were included in our study. Patients with a history of heart failure, malignancy, acute coronary syndrome, and myocarditis were excluded. RESULTS The median age of the study population was 69 (60-77 IQR) years, and 305 (38%) of these patients were men. There was no statistically significant difference between the patients who died during follow-up and cases that remained alive in terms of comorbidities except chronic obstructive pulmonary disease (COPD) which was significantly lower in surviving group (p=0.014). Multivariable logistic regression analysis revealed that age [OR: 1.04, CI (1.01-1.06); p=0.002], male gender [OR: 1.85, CI (1.13-3.02); p=0.010], lymphocyte count [OR: 0.63, CI (0.40-0.98); p=0.038], SaO2 [OR: 0.82, CI (0.79-0.85); p<0.001] and BAR level [OR: 1.09, CI (1.04-1.16); p=0.001] were independent predictors of in-hospital mortality. ROC analysis yielded that BAR is a better predictor of in-hospital mortality compared to albumin and BUN alone. CONCLUSIONS BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, and BAR was also found to be a more reliable predictor than BUN and albumin levels. Hypertension is one of the major risk factors for morbidity and mortality in COVID-19 and, BAR presents additional prognostic data in hypertensive COVID-19 patients that may direct physicians for treatment intensification.
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Affiliation(s)
- M Okşul
- Department of Cardiology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
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Seyrek Y, Cansever L, Akın H, Metin M, Bolat E, Bedirhan MA. The Significance of Skip Mediastinal Lymph Node Metastasis in the Prognosis of Patients with Resected Non-Small-Cell Lung Carcinoma: Is It Really a Better N2 Disease Subtype? Ann Thorac Cardiovasc Surg 2021; 27:304-310. [PMID: 33790147 PMCID: PMC8560541 DOI: 10.5761/atcs.oa.20-00289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: In this study, we aimed to reveal the prognostic differences between skip and non-skip metastasis mediastinal lymph node (MLN) metastasis. Methods: A total of 202 patients (179 males and 23 females; mean age, 59.66 ± 9.89 years; range: 29–84 years) who had ipsilateral single-station MLN metastasis were analyzed in two groups retrospectively between January 2009 and December 2017: “skip ipsilateral MLN metastasis” group (sN2) (n = 55,27.3%) [N1(–), N2(+)], “non-skip ipsilateral MLN metastasis” group (nsN2) (n = 147,72.7%) [N1(+), N2(+)]. Results: The mean follow-up was 42.63 ± 34.91 months (range: 2–117 months). Among all patients, and in the sN2 and nsN2 groups, the median overall survival times were 63.5 ± 4.56, 68.8 ± 7, and 59.3 ± 5.35 months, respectively, and the 5-year overall survival rates were 38.2%, 46.3%, and 36.4%. Conclusion: Skip metastasis did not take its rightful place in TNM classification; thus, further studies will be performed. To detect micrometastasis, future studies on skip metastasis should examine non-metastatic hilar lymph nodes (LNs) through staining methods so that heterogeneity in patient groups can be avoided, that is, to ensure that only true skip metastasis cases are included. Afterwards, more accurate and elucidative studies on skip metastasis can be achieved to propound its prognostic importance in the group of N2 disease.
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Affiliation(s)
- Yunus Seyrek
- Department of Thoracic Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Center, Istanbul, Turkey
| | - Levent Cansever
- Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Health Application and Research Center, Health Sciences University, Istanbul, Turkey
| | - Hasan Akın
- Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Health Application and Research Center, Health Sciences University, Istanbul, Turkey
| | - Muzaffer Metin
- Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Health Application and Research Center, Health Sciences University, Istanbul, Turkey
| | - Erkut Bolat
- Department of Biostatistics and Medical Informatics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Ali Bedirhan
- Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Health Application and Research Center, Health Sciences University, Istanbul, Turkey
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Ceritoğlu A, Sezen CB, Aker C, Girgin O, Akın H. Prognostic factors associated with morbidity and mortality after surgery for postintubation tracheal stenosis. Curr Thorac Surg 2020. [DOI: 10.26663/cts.2020.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Gülhan ŞE, Kılıçgün A, Samancılar Ö, Altınok T, Kutluk AC, Baysungur VS, Çelik MR, Akın H. Surgery for Pulmonary Hydatidosis in Turkey in 2014: A Nationwide Study. Turk Thorac J 2019; 20:120-124. [PMID: 30958984 DOI: 10.5152/turkthoracj.2018.18109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 09/25/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Turkey remains among the countries where hydatid disease is endemic. In this study, it was aimed to determine the number of operations performed for the treatment of pulmonary hydatid disease in Turkey during 2014 and to present the distribution of these operations according to the different regions of the country. MATERIALS AND METHODS The Turkish Thoracic Society Thoracic Surgery Study Group connected with the thoracic surgeons in each city through telephone. A data set was sent by email. The age, sex, contact with animals that might be a risk of gaining the hydatid disease, the side of the disease, the type of surgical method, other organ involvement were recorded and collected from each data set to form the final data, and the results were evaluated. Turkey comprises of 81 cities that are grouped in seven different regions. The number of operations was calculated for each city and region to present the distribution. RESULTS Overall, 101 centers from 81 cities were considered in the study. A total of 715 pulmonary hydatid cyst operations were performed in 690 patients during the study period. The most common operation technique was cystotomy and capitonnage through thoracotomy (76%). The highest incidence rate of operated patients was in the Eastern Anatolian Region (2.15 patients per 100 000 person-years). CONCLUSION Pulmonary hydatid disease still has a high incidence rate particularly in the southeast and east of Turkey, which are mainly rural areas and where stockbreeding is very common. Cystotomy and capitonnage is still the most common surgical method used to treat pulmonary hydatid cysts. Preventive methods should be performed strictly in these cities and regions to decrease the risk of infection.
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Affiliation(s)
- Şakir Erkmen Gülhan
- Clinic of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital, Ankara, Turkey
| | - Ali Kılıçgün
- Department of Thoracic Surgery, Abant İzzet Baysal University School of Medicine, Bolu, Turkey
| | - Özgür Samancılar
- Clinic of Thoracic Surgery, Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, İzmir, Turkey
| | - Tamer Altınok
- Department of Thoracic Surgery, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Ali Cevat Kutluk
- Clinic of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey
| | - Volkan Selami Baysungur
- Clinic of Thoracic Surgery, Süreyypaşa Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey
| | - Muhammet Reha Çelik
- Department of Thoracic Surgery, İnönü University School of Medicine, Malatya, Turkey
| | - Hasan Akın
- Clinic of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey
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Kutluk AC, Akın H. Comparison of the outcomes of the implanted subcutaneous ports in cancer patients: six-years single center experience. Curr Thorac Surg 2018. [DOI: 10.26663/cts.2019.00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Akın H, Kumbasar S, Şık B, Salman S, Temur M, Çakıroğlu F, Özyurt R, Küçükbaş M. Comparison of GnRH antagonist and agonist mini-dose long protocols in infertile cases undergoing controlled ovarian hyperstimulation. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3434.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kutluk AC, Kocatürk Cİ, Akın H, Bedirhan MA, Ceritoğlu A, Hatipoğlu M, Karapınar K, Saydam Ö. Pulmonary sequestration: is it fraught to operate without the diagnosis? Curr Thorac Surg 2016. [DOI: 10.26663/cts.2016.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kazak E, Akın H, Ener B, Sığırlı D, Özkan Ö, Gürcüoğlu E, Yılmaz E, Çelebi S, Akçağlar S, Akalın H. An investigation ofCandidaspecies isolated from blood cultures during 17 years in a university hospital. Mycoses 2014; 57:623-9. [DOI: 10.1111/myc.12209] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 04/24/2014] [Accepted: 05/23/2014] [Indexed: 11/27/2022]
Affiliation(s)
- E. Kazak
- Department of Infectious Diseases and Clinical Microbiology; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
| | - H. Akın
- Department of Infectious Diseases and Clinical Microbiology; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
| | - B. Ener
- Department of Medical Microbiology; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
| | - D. Sığırlı
- Department of Biostatistics; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
| | - Ö. Özkan
- Department of Microbiology; T.C. Ministry of Health Şevket Yılmaz Hospital; Bursa Turkey
| | - E. Gürcüoğlu
- Department of Infectious Diseases and Clinical Microbiology; Bursa Doruk Hospital; Yıldırım Bursa Turkey
| | - Emel Yılmaz
- Department of Infectious Diseases and Clinical Microbiology; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
| | - Solmaz Çelebi
- Department of Pediatrics; Faculty of Medicine; Uludag University; Görükle Bursa Turkey
| | - Sevim Akçağlar
- Department of Medical Microbiology; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
| | - Halis Akalın
- Department of Infectious Diseases and Clinical Microbiology; Faculty of Medicine; Uludağ University; Görükle Bursa Turkey
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Bedirhan MA, Cansever L, Demir A, Ceyhan S, Akın H, Urer HN, Olçmen A, Kocatürk C, Dinçer I. Which type of surgery should become the preferred procedure for malignant pleural mesothelioma: extrapleural pneumonectomy or extended pleurectomy? J Thorac Dis 2013; 5:446-54. [PMID: 23991301 DOI: 10.3978/j.issn.2072-1439.2013.07.40] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 07/29/2013] [Indexed: 11/14/2022]
Abstract
PURPOSES Since radiation and chemotherapy have limitations as therapies for malignant pleural mesothelioma (MPM). The type of surgery [extrapleural pneumonectomy (EPP), extended pleurectomy (E/P), and pleurectomy/decortication (P/D)] remains controversial. METHODS This study involves 76 consecutive patients. 58 of the cases were males (76%) with a median age of 53.17±10.93 years. EPP, E/P, and P/D were performed in 31, 20, and 25 cases, respectively. RESULTS The median survival time was 20 months in all patients. Overall, five-year survival rate was 14.3%. The survival rate was significantly better in epithelioid mesothelioma (P=0.049). For EPP cases, the median survival rate was 17 months, and the three-to-five year survival rates were 21% and 17%, respectively. For E/P cases, the median survival rate was 27 months and the three-year and four-year survival rates were 34% and 30%, respectively. For P/D cases, the median survival rate was 15 months and the three-to-five year survival rate was 13% and 0%. There were no statistically significant differences between the three surgical techniques (P=0.088). A comparative analysis indicates only a statistically significant difference in the E/P and P/D comparison (P=0.032). Hospital mortality showed a higher trend in EPP group (EPP: 12.9%, E/P: 0% and P/D: 4%, P=0.145). N2 cases, there were no cases of two-year survival. The survival rate in N2 was comparatively much lower, which was statistically significant (P=0.005). In multivariate analysis, only P/D (OR 0.3, 95% CI: 0.1-0.9, P=0.049) and N2 (OR 1.6, 95% CI: 0.9-2.6, P=0.090) were found to be poor prognostic factors. CONCLUSIONS E/P could be encouraged to EPP with lower mortality rate and better survival trend in MPM. N2 diseases were negative prognostic factors in MPM.
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Affiliation(s)
- Mehmet Ali Bedirhan
- Department of Surgery, Yedikule Hospital for Chest Disease, Istanbul, Turkey
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