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  • Article
    Citation - WoS: 5
    Patients With Crush Syndrome and Kidney Disease: Lessons Learned From the Earthquake in Kahramanmaras,, Türkiye
    (Elsevier Science inc, 2024) Ozturk, Savas; Tuglular, Serhan; Olmaz, Refik; Kocyigit, Ismail; Kibar, Muge Uzerk; Turgutalp, Kenan; Sever, Mehmet Sukru
    This study investigated in-hospital outcomes and related factors in patients diagnosed with postearthquake crush syndrome after the earthquakes in Kahramanmaras,, T & uuml;rkiye. One thousand twenty-four adult patients diagnosed with crush syndrome were analyzed. and outcomes were collected. A total of 9.8% of patients died during their hospital stay. Nonsurvivors were generally older, more likely to have preexisting chronic kidney disease, and faced more severe injuries and complications, including hypotension-shock, arrhythmias, elevated markers of renal dysfunction, and higher rates of acute kidney injury (AKI) and compartment syndrome. In addition, intensive care unit needs were higher. Multivariate analysis confirmed that age, injury severity, shock, high potassium, uric acid, and lactate levels on admission, development of AKI, compartment syndrome, and intensive care unit admission were significant predictors of mortality. Better disaster preparedness and improved health care infrastructure could be potential explanations for improved in-hospital mortality in the current era, as compared to previous earthquakes.
  • Article
    Citation - WoS: 170
    Mortality Analysis of Covid-19 Infection in Chronic Kidney Disease, Haemodialysis and Renal Transplant Patients Compared With Patients Without Kidney Disease: a Nationwide Analysis From Turkey
    (Oxford Univ Press, 2020) Ozturk, Savas; Turgutalp, Kenan; Arici, Mustafa; Odabas, Ali Riza; Altiparmak, Mehmet Riza; Aydin, Zeki; Ates, Kenan
    Background. Chronic kidney disease (CKD) and immunosuppression, such as in renal transplantation (RT), stand as one of the established potential risk factors for severe coronavirus disease 2019 (COVID-19). Case morbidity and mortality rates for any type of infection have always been much higher in CKD, haemodialysis (HD) and RT patients than in the general population. A large study comparing COVID-19 outcome in moderate to advanced CKD (Stages 3-5), HD and RT patients with a control group of patients is still lacking. Methods. We conducted a multicentre, retrospective, observational study, involving hospitalized adult patients with COVID-19 from 47 centres in Turkey. Patients with CKD Stages 3-5, chronic HD and RT were compared with patients who had COVID-19 but no kidney disease. Demographics, comorbidities, medications, laboratory tests, COVID-19 treatments and outcome [in-hospital mortality and combined in-hospital outcome mortality or admission to the intensive care unit (ICU)] were compared. Results. A total of 1210 patients were included [median age, 61 (quartile 1-quartile 3 48-71) years, female 551 (45.5%)] composed of four groups: control (n = 450), HD (n = 390), RT (n = 81) and CKD (n = 289). The ICU admission rate was 266/1210 (22.0%). A total of 172/1210 (14.2%) patients died. The ICU admission and in-hospital mortality rates in the CKD group [114/289 (39.4%); 95% confidence interval (CI) 33.9-45.2; and 82/289 (28.4%); 95% CI 23.9-34.5)] were significantly higher than the other groups: HD = 99/390 (25.4%; 95% CI 21.3-29.9; P < 0.001) and 63/390 (16.2%; 95% CI 13.0-20.4; P < 0.001); RT = 17/81 (21.0%; 95% CI 13.2-30.8; P = 0.002) and 9/81 (11.1%; 95% CI 5.7-19.5; P = 0.001); and control = 36/450 (8.0%; 95% CI 5.8-10.8; P < 0.001) and 18/450 (4%; 95% CI 2.5-6.2; P < 0.001). Adjusted mortality and adjusted combined outcomes in CKD group and HD groups were significantly higher than the control group [hazard ratio (HR) (95% CI) CKD: 2.88 (1.52-5.44); P = 0.001; 2.44 (1.35-4.40); P = 0.003; HD: 2.32 (1.21-4.46); P = 0.011; 2.25 (1.23-4.12); P = 0.008), respectively], but these were not significantly different in the RT from in the control group [HR (95% CI) 1.89 (0.76-4.72); P = 0.169; 1.87 (0.81-4.28); P = 0.138, respectively]. Conclusions. Hospitalized COVID-19 patients with CKDs, including Stages 3-5 CKD, HD and RT, have significantly higher mortality than patients without kidney disease. Stages 3-5 CKD patients have an in-hospital mortality rate as much as HD patients, which may be in part because of similar age and comorbidity burden. We were unable to assess if RT patients were or were not at increased risk for in-hospital mortality because of the relatively small sample size of the RT patients in this study.
  • Article
    Citation - WoS: 2
    Citation - Scopus: 2
    Prognostic Implications and Predictors of Mitral Regurgitancy Reduction After Transcatheter Aortic Valve Implantation
    (Mdpi, 2024) Guney, Murat Can; Suygun, Hakan; Polat, Melike; Ayhan, Huseyin; Keles, Telat; Ertop, Zeynep Seyma Turinay; Bozkurt, Engin
    Background: Mitral regurgitation (MR) is a common condition observed in patients undergoing transcatheter aortic valve implantation (TAVI) for the treatment of aortic stenosis (AS). However, the impact of TAVI on MR outcomes and the factors predicting MR improvement remains uncertain. Understanding these predictors can enhance patient management and guide clinical decisions. Methods: This retrospective cohort study included 156 patients with moderate to severe MR undergoing TAVI. MR severity was assessed via echocardiography at baseline, as well as 6 months and 1 year after TAVI. Patients were divided into groups based on MR reduction: no improvement or worsening, one-degree improvement, and at least two-degree improvement. Clinical, echocardiographic, and procedural characteristics were evaluated as predictive factors for MR improvement after TAVI. Results: MR reduction occurred in 68% of patients at 6 months and 81% at 1 year. Factors predicting a reduction of two grades or more in MR severity included lower baseline LVEDD (OR = 1.345, 95% CI: 1.112-1.628, p = 0.002) lower baseline LA (OR = 1.121, 95% CI: 1.015-1.237, p = 0.024), lower baseline LVMI (OR = 1.109, 95% CI: 1.020-1.207, p = 0.024), and higher baseline EF levels (OR = 1.701, 95% CI: 1.007-2.871, p = 0.047). No significant association was found between MR reduction at 6 months and one-year mortality. (p = 0.65). Conclusions: Baseline echocardiographic parameters are valuable in predicting MR improvement post-TAVI, with LVMI emerging as a novel predictor. However, MR reduction did not independently predict survival, underscoring the need for further research to optimize patient selection and management strategies in TAVI candidates.