13 research outputs found
Contributing factors to mortality rates of pulmonary tuberculosis in intensive care units
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Study on factors affecting mortality in nonagenarian patients in orthopaedic surgery
No full textBackground: With medicine advancing, population is aging in the world. We encounter elderly patients in operating rooms more often. In this study, the aim was to investigate mortality and morbidity rates of patients 90 years of age or older within 1 year from the date of operation due to fractures.Methods: The study was performed retrospectively in the 3rd stage health institution. All patients that had fracture operation in the operating rooms of the orthopaedics department between 2011 and 2017 and that were 90 years or older on the day of operation were included in the study. Patients who were operated twice were excluded from the study.Results: Around 83 patients of which were included in the study. The mean age of the patients was 92.89±2.84. In-hospital mortality rate was 8.4%. The mortality rate within 3 months from the operation was 18.1%, 25.3% within 1 year, and 61.4% within 5 years or above. Author found that the mean survival period for the total of the surviving patients was 23.87±18.96 months. Author found that there was a meaningful causation between morbidity developing post-operation and in-hospital mortality, 3-month mortality, and 1-year mortality (p<0.05).Conclusions: Author think that it was important to recognize the fact that despite being more vulnerable, patients 90 years of age or older have a significant life expectancy post-hospital discharge. Author think that post-operation acute morbidity affects mortality rates and it was important to avoid factors that may cause acute morbidity in patients 90 years of age and older
Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use in acute respiratory failure
No full textIntroduction: Noninvasive mechanical ventilation (NIV) has been increasingly used worldwide for acute respiratory failure (ARF), especially in patients with chronic lung disorders. We aimed to define the approach of pulmonologists in Turkey to NIV use for ARF management. Materials and Methods: A 38-question survey, developed and tested by authors, was distributed by e-mail to a total of 2.205 pulmonologists in Turkey. Results: Response rate was 27% (n=596). Seventy-one percent of responders were practicing NIV in clinic. NIV use was found to be associated with responder's academic title, age, duration of medical license, type of physician's hospital and its region, patient load, NIV experience during residency, and duration of NIV and intensive care unit (ICU) experience (p<0.001). Based on sub-group analysis of responders using NIV, median number of NIV patients followed-up per week was 4 [interquartile range (IQR): 2-6]. Most of the NIV users reported employment of wards (90%) and/or ICUs (86%) to follow-up patients, while 8.4% of the responders were applying NIV only in ICU's. Chronic obstructive lung disease (COPD) (99.5%), obesity hypoventilation syndrome (93.7%) and restrictive lung disease (89.4%) were the most common indications. Majority of NIV users (87%) were applying NIV to > 60% of patients with COPD, and success rate in COPD was reported as over 60% by 93% of users. Oronasal mask (median and IQR 90, 80-100%, respectively) and home care NIV ventilators (median and IQR 50, 10-85%, respectively) were the most commonly utilized equipment. Conclusion: NIV use in ARF varies based on hospital type, region and, especially, experience of the physician. Although consistent with guidelines and general practice, NIV use can still be improved and increased
Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use at home for chronic respiratory failure
No full textIntroduction: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation ( NIV) use for chronic respiratory failure ( CRF), the most currently applied technique for home mechanical ventilation. Patients and Methods: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. Results: Twenty-seven percent of the pulmonologists responded ( n= 596). Domiciliary NIV was reported to be prescribed by 340 physicians [ 57.1% of all responders and 81% of pulmonologists practicing NIV at clinical practice ( n= 420)]. NIV prescription was associated with physician's title, type of hospital, duration of medical license, total number of patients treated with NIV during residency and current number of patients treated with NIV per week ( p< 0.05). Main estimated indications were listed as chronic obstructive pulmonary disease ( median, 25-75 percentile of the prescriptions: 75%, 60-85), obesity hypoventilation syndrome ( 10%, 2-15), overlap syndrome ( 10%, 0-20) and restrictive lung disease ( 5%, 2-10). For utilization of NIV at home, Bilevel positive airway pressure-spontaneous mode ( 40%, 0-80) and oronasal mask ( 90%, 60-100) were stated as the most frequently recommended mode and interface, respectively. Pressure settings were most often titrated based on arterial blood gas findings ( 79.2%). Humidifier was stated not to be prescribed by approximately half of the physicians recommending domicilliary NIV, and the main reason for this ( 59.2%) was being un-refundable by social security foundation. Conclusion: There is a wide variation in Turkey for prescription of NIV, which is supposed to improve clinical course of patients with CRF. Further studies are required to determine the possible causes of these differences, frequency of use and patient outcomes in this setting
Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use at home for chronic respiratory failure
No full textWOS: 000386262800001PubMed ID: 27266279Introduction: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation ( NIV) use for chronic respiratory failure ( CRF), the most currently applied technique for home mechanical ventilation. Patients and Methods: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. Results: Twenty-seven percent of the pulmonologists responded ( n= 596). Domiciliary NIV was reported to be prescribed by 340 physicians [ 57.1% of all responders and 81% of pulmonologists practicing NIV at clinical practice ( n= 420)]. NIV prescription was associated with physician's title, type of hospital, duration of medical license, total number of patients treated with NIV during residency and current number of patients treated with NIV per week ( p< 0.05). Main estimated indications were listed as chronic obstructive pulmonary disease ( median, 25-75 percentile of the prescriptions: 75%, 60-85), obesity hypoventilation syndrome ( 10%, 2-15), overlap syndrome ( 10%, 0-20) and restrictive lung disease ( 5%, 2-10). For utilization of NIV at home, Bilevel positive airway pressure-spontaneous mode ( 40%, 0-80) and oronasal mask ( 90%, 60-100) were stated as the most frequently recommended mode and interface, respectively. Pressure settings were most often titrated based on arterial blood gas findings ( 79.2%). Humidifier was stated not to be prescribed by approximately half of the physicians recommending domicilliary NIV, and the main reason for this ( 59.2%) was being un-refundable by social security foundation. Conclusion: There is a wide variation in Turkey for prescription of NIV, which is supposed to improve clinical course of patients with CRF. Further studies are required to determine the possible causes of these differences, frequency of use and patient outcomes in this setting
Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use at home for chronic respiratory failure
No full textIntroduction: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation ( NIV) use for chronic respiratory failure ( CRF), the most currently applied technique for home mechanical ventilation. Patients and Methods: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. Results: Twenty-seven percent of the pulmonologists responded ( n= 596). Domiciliary NIV was reported to be prescribed by 340 physicians [ 57.1% of all responders and 81% of pulmonologists practicing NIV at clinical practice ( n= 420)]. NIV prescription was associated with physician's title, type of hospital, duration of medical license, total number of patients treated with NIV during residency and current number of patients treated with NIV per week ( p< 0.05). Main estimated indications were listed as chronic obstructive pulmonary disease ( median, 25-75 percentile of the prescriptions: 75%, 60-85), obesity hypoventilation syndrome ( 10%, 2-15), overlap syndrome ( 10%, 0-20) and restrictive lung disease ( 5%, 2-10). For utilization of NIV at home, Bilevel positive airway pressure-spontaneous mode ( 40%, 0-80) and oronasal mask ( 90%, 60-100) were stated as the most frequently recommended mode and interface, respectively. Pressure settings were most often titrated based on arterial blood gas findings ( 79.2%). Humidifier was stated not to be prescribed by approximately half of the physicians recommending domicilliary NIV, and the main reason for this ( 59.2%) was being un-refundable by social security foundation. Conclusion: There is a wide variation in Turkey for prescription of NIV, which is supposed to improve clinical course of patients with CRF. Further studies are required to determine the possible causes of these differences, frequency of use and patient outcomes in this setting
Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use in acute respiratory failure
No full textCan we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV Mortality Prediction Score (IMPRES)
No full textConclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data
Mortality prediction ability of phycians in intensive care units of Turkey (MOPAP)
No full textIntroduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up
