Sürdürülebilir Kalkınma Amaçları

• 5

Yazarlar

• Günes, Murat(2)
• Akbas, Turkay(1)
• Akcay, Murat(1)
• Albayrak, Tuna(1)
• Alpdog, Ozcan(1)
• Aydin, Kaniye(1)
• Bayrak, Vecihe(1)
• Binay, Songul(1)
• Boyaci, Faruk(1)
• Caglioglu, Hakan(1)
• Civici, Huseyin(1)
• Dal, Hayriye Cankar(1)
• Dicle, Cilem Bayindir(1)
• Dönmez, Gul Erdal(1)
• Emgin, Omer(1)
• Ergan, Begum(1)
• Ergün, Bisar(1)
• Erkoyun, Erdem(1)
• Ertaş, Gökhan(1)
• Eser, Mustafa(1)
• Eyüpoglu, Selin(1)
• Gaygisiz, Ummugulsum(1)
• Gökmen, Necati(1)
• Hanci, Pervin(1)
• Inal, Mehmet Turan(1)
• Kara, Ekrem(1)
• Kaya, Enes(1)
• Kilinç, Ahmet(1)
• Kiliç, Ozgur(1)
• Kiliç, Teoman(1)
• Kirakli, Cenk(1)
• Kokcu, Halil Ibrahim(1)
• Konur, Kamil(1)
• Kozdaǧ, Güliz(1)
• Koçak, Gamze(1)
• Kökalan, Damla(1)
• Mentes, Oral(1)
• Ozturk, Berkant(1)
• Rollas, Kazim(1)
• Sahin, Adem(1)

• MakaleAçık Erişim2026Scopus SJRQ2/r/gumushane/16439
  The COPD-augmented R2CHA2DS2-VA score: development and internal assessment for predicting one-year outcomes after transcatheter aortic valve implantation

  Boyaci, Faruk; Sahin, Mustafa Kursat; Akcay, Murat; Yanik, Ahmet; Yenercag, Mustafa; Seker, Onur Osman; Ucar, Melisa; Kokcu, Halil Ibrahim; Ozturk, Berkant; Kaya, Enes

  Background Existing CHA(2)DS(2)-VASc-based scores incompletely capture the prognostic impact of chronic obstructive pulmonary disease (COPD) and of graded renal dysfunction in patients undergoing transcatheter aortic valve implantation (TAVI). We acknowledge that the score's development in a high-risk, high-comorbidity cohort may produce optimistic performance estimates that require attenuation through external validation. We aimed to develop a novel COPD-augmented R(2)CHA(2)DS(2)-VA (COPD-R(2)CHA(2)DS(2)-VA) score that systematically integrates quantitative renal function and COPD, and to internally assess its discriminative performance for one-year all-cause mortality and major adverse cardiovascular events (MACE). Methods In this single-center, retrospective cohort study, 622 consecutive patients undergoing TAVI for severe aortic stenosis (2018-2024) were analyzed. The COPD-R(2)CHA(2)DS(2)-VA score was constructed as a prespecified clinical tool by augmenting the R(2)CHA(2)DS(2)-VA framework with COPD (1 point) and refining renal dysfunction into two graded estimated glomerular filtration rate strata (eGFR 30-59 mL/min/1.73 m & sup2;: 1 point; eGFR < 30: 2 points). Discriminative performance was evaluated using receiver operating characteristic curve analysis with bootstrap internal validation (2,000 resamples) and compared with established CHA(2)DS(2)-VASc-based scores. Multivariable logistic regression assessed the independent prognostic value of the score treated as a continuous variable. Results The COPD-R(2)CHA(2)DS(2)-VA score demonstrated encouraging discriminative ability for one-year all-cause mortality (apparent area under the curve [AUC] 0.946, 95% CI 0.926-0.971). As a prespecified tool with fixed component weights, bootstrap internal validation confirmed negligible optimism (mean optimism - 0.00014), with bias-corrected AUC identical to the apparent value. The addition of COPD significantly improved mortality discrimination over the R(2)CHA(2)DS(2)-VA score (Delta AUC + 0.033, p = 0.0001). For one-year MACE, the apparent AUC was 0.806 (95% CI 0.765-0.852); the addition of COPD did not significantly enhance MACE discrimination (Delta AUC + 0.001, p = 0.853). In multivariable analysis, each one-point increase in the COPD-R(2)CHA(2)DS(2)-VA score was independently associated with 3.52-fold higher odds of one-year mortality (95% CI 2.45-5.06, p < 0.001) and 2.02-fold higher odds of MACE (95% CI 1.67-2.46, p < 0.001). The bias-corrected AUC of the full multivariable model was 0.973 (95% CI 0.962-0.984) for mortality and 0.795 (95% CI 0.752-0.841) for MACE. Conclusions The COPD-R(2)CHA(2)DS(2)-VA score demonstrated encouraging discriminative ability for one-year all-cause mortality after TAVI in this single-center development cohort (apparent AUC 0.946). However, this high discriminative performance is likely influenced by the elevated comorbidity burden in our cohort and the single-center design, and should be interpreted as an upper-bound estimate. The addition of COPD provides a statistically significant but clinically modest incremental improvement for mortality (Delta AUC + 0.033, p = 0.0001), with no significant enhancement for MACE (Delta AUC + 0.001, p = 0.853). These findings are preliminary and hypothesis-generating; urgent external validation in diverse, prospective cohorts is essential before any clinical application can be considered. At present, this score should be regarded as a development-phase, hypothesis-generating tool that complements rather than replaces guideline-recommended instruments such as STS-PROM and EuroSCORE II. The score's clinical utility remains unproven.

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  İncele
• MakaleAçık Erişim2026Scopus SJRQ2/r/gumushane/15845
  Association of Serial Intra-Abdominal Pressure Measurements with Renal Outcomes and Mortality in Critically Ill Adults

  Öztürk, Ayse Sari; Konur, Kamil; Kara, Ekrem

  Background/Objectives: Intra-abdominal hypertension (IAH) is a common but under-recognized condition in critically ill patients and is associated with adverse outcomes, particularly acute kidney injury (AKI) and mortality. However, the prognostic value of intra-abdominal pressure (IAP) remains incompletely defined. This study aimed to evaluate the association between IAP levels and clinical outcomes, and to determine its prognostic significance in intensive care unit (ICU) patients. Methods: This prospective cohort study included adult patients admitted to the ICU between 2024 and 2025. Serial IAP measurements were performed using the transvesical method on days 0, 1, 3, 5, and 7. Demographic, clinical, and laboratory data, along with severity scores (SOFA and APACHE II), were recorded. Patients were followed for 90 days. Primary outcomes were AKI and 90-day mortality. Statistical analyses included regression models, survival analysis, and ROC curve analysis. Results: The prevalence of IAH was 54%. IAH was significantly associated with advanced age, male sex, higher body mass index, increased comorbidity burden, sepsis, positive fluid balance, and higher disease severity scores. Patients with IAH had a significantly higher frequency of AKI occurrence and increased mortality. IAP levels positively correlated with serum urea and creatinine levels. Serial IAP measurements, particularly on days 5 and 7, showed progressively improved predictive performance for mortality. Survival analysis revealed significantly reduced survival in patients with IAH. Conclusions: IAH is highly prevalent in critically ill patients and is strongly associated with renal dysfunction and mortality. Serial IAP measurements may provide useful prognostic information in critically ill patients; however, these findings require validation in larger studies.

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  AtıfOpenAlex1

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• MakaleAçık Erişim2024Scopus SJRQ1/r/gumushane/16303
  The Association Between Glycemic Variability and Mortality in Critically Ill Patients: A Multicenter Prospective Observational Study

  Emgin, Omer; Yavuz, Mehmet; Sahin, Adem; Günes, Murat; Eser, Mustafa; Yavuz, Tunzala; Kökalan, Damla; Ergün, Bisar; Rollas, Kazim; Çakirgöz, Mensure Yilmaz

  Background: Glycemic variability (GV) is a prevalent and significant condition observed in critically ill patients. This study aimed to investigate the relationship between early glycemic variability parameters and 28-day mortality in critically ill patients. Methods: A multicenter, prospective, and observational study was performed at five tertiary intensive care units (ICUs) in Turkey. All patients who had more than six blood glucose level (BGL) measures per 24 h were included. The parameters of GV including the SD, MGL, MGD (the difference between the maximal and minimal glucose level), and the CV (the percentage of SD to the MGL) in the first 24 h were recorded. Results: A total of 578 eligible patients were enrolled in the study, of whom 43.6% were women. The mean age of the patients was 68.09 +/- 16.62 years. Overall mortality was 31.5% (n = 182). The glycemic parameters of the CV, SD, and MGD were significantly higher in the non-survivor group than in the survivor group (p = 0.040, 0.006, and 0.002, respectively). The multivariate logistic regression analysis revealed that the CV (OR 1.023; 95% CI 1.004-1.042; p = 0.017) was an independent factor that increased mortality. Spearman's rho correlation analysis revealed a strong (r:0.871) and statistically significant correlation (p < 0.001) between the CV and MGD. Conclusions: The CV calculated within the first 24 h of ICU admission is independently associated with 28-day mortality. The MGD is correlated with the CV and is maybe a practical tool to predict increased risk of mortality at the bedside. However, further studies are needed to establish the independent association of the MGD with mortality.

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  AtıfWoS13·OpenAlex11

  İncele
• MakaleAçık Erişim2023Scopus SJRQ2/r/gumushane/10687
  Vaccination status of COVID-19 patients followed up in the ICU in a country with heterologous vaccination policy: A multicenter national study in Turkey

  Yildirim, Suleyman; Erkoyun, Erdem; Alpdog, Ozcan; Yilmaz, Huseyin Oguz; Yilmaz, Baris; Dönmez, Gul Erdal; Saritas, Aykut; Gökmen, Necati; Ergan, Begum; Bayrak, Vecihe

  Objective: Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-2) prevents the development of serious diseases has been shown in many studies. However, the effect of vaccination on outcomes in COVID-19 patients requiring intensive care is not clear.Methods: This is a retrospective multicenter study conducted in 17 intensive care unit (ICU) in Turkey between January 1, 2021, and December 31, 2021. Patients aged 18 years and older who were diagnosed with COVID-19 and followed in ICU were included in the study. Patients who have never been vaccinated and patients who have been vaccinated with a single dose were considered unvaccinated. Logistic regression models were fit for the two outcomes (28-day mortality and in-hospital mortality).Results: A total of 2968 patients were included final analysis. The most of patients followed in the ICU during the study period were unvaccinated (58.5%). Vaccinated patients were older, had higher Charlson comorbidity index (CCI), and had higher APACHE-2 scores than unvaccinated patients. Risk for 28-day mortality and in-hospital mortality was similar in across the year both vaccinated and unvaccinated patients. However, risk for in-hospital mortality and 28-day mortality was higher in the unvaccinated patients in quarter 4 adjusted for gender and CCI (OR: 1.45, 95% CI: 1.06-1.99 and OR: 1.42, 95% CI: 1.03-1.96, respectively) compared to the vaccinated group.Conclusion: Despite effective vaccination, fully vaccinated patients may be admitted to ICU because of disease severity. Unvaccinated patients were younger and had fewer comorbid conditions. Unvaccinated patients have an increased risk of 28-day mortality when adjusted for gender and CCI.

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  AtıfWoS2·OpenAlex3

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• MakaleYalnız künye2012Scopus SJRQ2/r/gumushane/15681
  Aspirin, clopidogrel, and warfarin use and outcomes in a cohort of 580 patients discharged after hospitalization for decompensated heart failure

  Kozdaǧ, Güliz; Yaymaci, Mehmet; Ertaş, Gökhan; Çelikyurt, Umut; Şahin, Tayfun; Kiliç, Teoman; Ural, Dilek

  The benefits of taking of aspirin, clopidogrel, and warfarin in relation to cardiovascular mortality and re-hospitalization in chronic heart failure (HF) patients have been called into question. We examined the outcomes (cardiac mortality and/or HF re-hospitalization) in patients discharged from our hospital between January 2003 and July 2009 after hospitalization for chronic decompensated HF. Of 580 HF patients (mean age, 63 ± 13 years; mean ejection fraction, 26 ± 9%, 63% with coronary disease and 37% without coronary disease), 207 patients (36%) died due to cardiovascular reasons, and 313 (54%) required HF re-hospitalization for decompensated HF during a 39 ± 14 month follow-up period. 101 (17%) patients were taking clopidogrel during enrollment in the study. When comparing patients who were on clopidogrel treatment with those who were not, clopidogrel was found to have a beneficial effect on cardiac mortality (27 vs. 38%, P = 0.04). In conclusion, in this observational prospective study, patients who used clopidogrel showed decreased cardiac mortality [HR, 0.566 (95% CI 0.332-0.964), P = 0.036] compared to patients who did not take clopidogrel. Clopidogrel had a beneficial effect on the survival of chronic HF patients in the long term.

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  AtıfScopus10·OpenAlex10

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