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Öğe A Retrospective Evaluation of the Cardiometabolic Profile of Patients with COPD-Related Type 2 Respiratory Failure in the Intensive Care Unit(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Ensarioglu, Kerem; Cirik, Mustafa Ozgur; Peker, Tulay Tuncer; Canbay, FatmaBackground and Objectives: Chronic obstructive pulmonary disease (COPD) is a notable cause of morbidity and mortality worldwide and can become complicated by Type 2 respiratory failure. This study aimed to analyze the cardiological and metabolic comorbidities of patients admitted to the intensive care unit (ICU) due to COPD-related Type 2 respiratory failure and evaluate their effects on clinical outcomes. Materials and Methods: A retrospective analysis was conducted on 258 patients admitted to the secondary-level pulmonary disease intensive care unit between January 2022 and January 2024. Patients' demographic data, cardiological and metabolic comorbidities, laboratory parameters, and ICU-related variables were evaluated using statistical analysis methods. Results: The most common comorbidities were hypertension (57.0%), congestive heart failure (48.1%), diabetes mellitus (31.4%), and obesity (37.6%). Female patients had significantly higher rates of hypothyroidism, hypertension, obesity, and congestive heart failure compared to males. Patients diagnosed with chronic kidney disease (CKD) had markedly higher cardiothoracic ratios and proBNP levels. ICU length of stay was considerably longer in patients with acute kidney injury (AKI) and coronary artery disease (CAD). Cardiomegaly and obstructive sleep apnea syndrome (OSAS) were more frequently observed in obese patients. Additionally, in COPD patients, a body mass index (BMI) threshold of 25.5 was determined as a cutoff value for radiological cardiomegaly findings with a sensitivity of 69.9% and a specificity of 59.5%. Elevated pCO2 and bicarbonate levels in patients receiving long-term oxygen therapy (LTOT) were associated with advanced-stage COPD. Conclusions: Metabolic and cardiological comorbidities notably impact the clinical prognosis and ICU management of patients diagnosed with COPD and Type 2 respiratory failure. This study, which aims to provide a snapshot of the comorbidities in patients requiring ICU admission due to COPD exacerbation-related Type 2 respiratory failure but without a fatal course, seeks to highlight the key areas where preventive and protective healthcare services should be focused in this patient group. Special attention should be given to monitoring female and obese patients. Future studies should explore how individualized and preventive follow-ups and treatment approaches can improve patient outcomes, with a particular emphasis on these identified areas.Öğe Atrial Fibrillation Among ICU Patients with Type 2 Respiratory Failure: Who Is at Risk and What Are the Outcomes?(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Ozdemir, Tarkan; Ari, Maside; Aksoy Guney, Eda Nur; Ari, EmrahBackground: Atrial fibrillation (AF) frequently occurs in individuals with hypercapnic type 2 respiratory failure and has the potential to adversely affect patient outcomes. This study sought to investigate the clinical features and prognostic significance of atrial fibrillation in patients admitted to the intensive care unit with hypercapnic type 2 respiratory failure. Methods: This retrospective, single-center study included 200 adult patients diagnosed with hypercapnic type 2 respiratory failure between May 2022 and May 2023. Patients were grouped according to whether atrial fibrillation was present or not. Demographic, laboratory, and echocardiographic findings, comorbidities, and outcomes were compared. Kaplan-Meier survival analysis and Cox regression were used to identify mortality predictors. Results: AF was present in 50.5% of patients. Those with AF were older, had higher Charlson Comorbidity Index scores, and a greater prevalence of heart failure (p < 0.001). No significant differences were found in arterial blood gas values. AF patients had higher urea, creatinine, and BNP levels, and lower hemoglobin, lymphocyte, eosinophil, and monocyte counts (p < 0.05). Echocardiography showed more severe tricuspid and mitral regurgitation, lower ejection fractions, and higher systolic pulmonary pressures in the AF group. About 20% of AF patients were not receiving anticoagulants at ICU admission. AF was associated with shorter survival (49.6 +/- 4.07 vs. 61.4 +/- 3.8 days, p = 0.031) and 1.6-fold higher mortality risk (HR: 1.60, 95% CI: 1.04-2.47). Advanced age and low hemoglobin were independent predictors of mortality. Conclusions: AF is frequent among patients with type 2 respiratory failure and is linked to increased mortality. Despite known complications, treatment remains underutilized. AF should be actively screened during ICU admissions for respiratory failure.Öğe Culture Positivity and Antibiotic Resistance in Respiratory Intensive Care Patients: Evaluation of Readmission and Clinical Outcomes(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Ensarioglu, Kerem; Ari, Maside; Cirik, Mustafa Ozgur; Kahraman, AbdullahBackground: Multidrug-resistant bacteria (MDRB) represent a significant challenge in intensive care units (ICUs), as they limit treatment options, prolong hospital stays, and escalate healthcare costs. Respiratory ICUs are particularly affected due to the high prevalence of chronically ill patients with recurrent infections. Understanding the impact of culture positivity and MDRB on clinical outcomes and readmission rates is essential for enhancing patient care and addressing the growing burden of antimicrobial resistance. Methods: This retrospective study was conducted in a specialized respiratory ICU at a tertiary care hospital between 1 January 2019, and 1 January 2020. A total of 695 ICU admissions were analyzed, with patients grouped based on readmission status and culture results. Demographic, clinical, and laboratory data were reviewed. Statistical analyses were performed using appropriate tests, with p-values <= 0.05 considered statistically significant. Results: Among the 519 unique patients, 65 experienced ICU readmissions. Male patients were significantly more likely to be readmitted (p = 0.008). Culture positivity was predominantly observed in respiratory samples, with Klebsiella spp. identified as the most common pathogen. MDRB prevalence exceeded 60% in both groups, significantly prolonging ICU stays (p = 0.013). However, no significant differences in survival rates were observed between MDRB-positive and MDRB-negative groups. Notably, patients with readmissions had lower C-reactive protein (CRP) levels both during admission and at discharge compared to non-readmitted patients (p = 0.004). This paradox may reflect a subclinical inflammatory response associated with bacterial colonization rather than active infection, particularly in patients with chronic respiratory diseases. Conclusions: MDRB infections and culture positivity are key contributors to prolonged ICU stays, resulting in increased healthcare costs. Implementing effective strategies to manage MDRB infections is critical for improving outcomes in respiratory ICUs and reducing associated risks. This study underscores the growing burden of MDRB and highlights the importance of enhanced antimicrobial stewardship in respiratory ICUs.Öğe Electrolyte Imbalance and Its Prognostic Impact on All-Cause Mortality in ICU Patients with Respiratory Failure(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Kahraman, Abdullah; Cirik, Mustafa Ozgur; Doganay, Guler Eraslan; Ensarioglu, KeremBackground and Objectives: Chronic obstructive pulmonary disease (COPD) and acute respiratory failure are critical clinical conditions associated with high mortality rates in intensive care units (ICUs). Electrolyte imbalances are significant variables that may influence all-cause ICU mortality in this patient group. In this retrospective study, we aimed to investigate the relationships between the serum levels of sodium (Na+), chloride (Cl-), potassium (K+), calcium (Ca-2(+)), and magnesium (Mg-2(+)) and all-cause ICU mortality in patients admitted with respiratory failure. Additionally, we conducted a detailed mortality analysis on the basis of sodium quartiles and pathological absolute sodium thresholds to reveal their associations with ICU mortality from all causes. Materials and Methods: A total of 1109 patients were analyzed between January 2022 and January 2024. The electrolyte levels measured at ICU admission, demographic data, APACHE II and SOFA scores, arterial blood gas results, BUN and creatinine levels, need for noninvasive mechanical ventilation, length of ICU stay, and survival outcomes were assessed. Statistical analyses were performed via Kaplan-Meier survival analysis and the Cox regression method. Results: Our findings revealed that patients with low potassium and calcium levels had significantly higher mortality rates (p < 0.05). When sodium levels were divided into quartiles, mortality risk markedly increased in both the lowest (Q1) and highest (Q4) quartiles. Cox regression analysis revealed that the mortality risk in hyponatremic patients was 2.2 times greater than that in normonatremic patients (p = 0.005). In the hyponatremic group, the increased mortality risk was statistically borderline significant (p = 0.06). In the logistic regression analysis conducted to evaluate ICU mortality, which included all electrolyte levels and clinical scoring systems, higher APACHE II and SOFA scores were identified as significant risk factors for ICU mortality. Conversely, the presence of COPD was found to be relatively protective compared with other underlying causes of respiratory failure in terms of mortality. Conclusions: Electrolyte imbalances are important predictors of mortality in patients with respiratory failure. Sodium levels exhibit a U-shaped relationship with mortality, with hyponatremia emerging as a prominent risk factor. Careful assessment of electrolyte imbalances is crucial in the clinical management of these patients.Öğe Evaluation of Respiratory Intensive Care Experiences and Relationships with Nutritional Status Among Patients Admitted to the Intensive Care Unit(Mdpi, 2025) Yildiz, Murat; Celik, Deniz; Ozdemir, Tarkan; Ensarioglu, Kerem; Cakir, Melek; Savur, Tugce Dondu; Mentes, OralBackground and Objectives: This study aimed to evaluate patients' experiences in the intensive care unit (ICU) setting and investigate whether there was a correlation between these experiences and their nutritional status. Materials and Methods: This study included patients admitted to the respiratory ICU between 1 January 2023 and 31 December 2023. Only patients aged 18 years or older were eligible for inclusion. Written and verbal consent was obtained from all participants, while those unable to provide nonverbal communication were excluded from the study. The Intensive Care Experience Questionnaire (ICEQ), developed by Rattray et al. in 2004, was utilized to assess the overall experiences of ICU patients. Results: The ICEQ results were analyzed across four categories: awareness of surroundings, recall of experiences, frightening experiences, and satisfaction with care. A total score was generated by summing the scores of these four categories. While the initial parameters were analyzed as ordinal data, the results for the four subcategories and the total score followed a parametric distribution and were thus analyzed accordingly. Conclusions: These findings reinforce the hypothesis that nutritional support requirements play a critical role in shaping patients' experiences in the ICU, regardless of their preadmission status. Adequate nutritional support was shown to have a positive effect on ICU experience.Öğe Factors Affecting the Length of Hospital Stay in Hypercapnic Respiratory Failure(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Ari, Maside; Özdemir, Tarkan; Yildiz, Murat; Çelik, Deniz; Usul, Eren; Ari, Emrah; Tuten, Omer FarukBackground/Objectives: Hypercapnic respiratory failure (HRF) is a primary cause of admittance to the intensive care unit (ICU). This study aimed to investigate the factors that affect the length of hospital stay in HRF patients. Methods: This study was designed as a retrospective, cross-sectional analysis of patients who were admitted to the ICU because of HRF between 2022 and 2024. The demographic and clinical characteristics of the patients and laboratory results were recorded. The Charlson Comorbidity Index (CCI) was calculated. The relationship between these parameters and the length of hospital stay was assessed. Results: A total of 138 patients were included in the study. The average length of hospital stay was 11.45 days, and 37% of the patients were included in the long-term hospitalization group. The degree of hypercapnia was not associated with the length of hospital stay. It was determined that the patients’ albumin levels and CCI were significant determinants of the length of hospital stay. The combined assessment of these two parameters was found to be superior compared to their separate evaluations. Conclusions: In our study, hypoalbuminemia and a higher CCI were identified as predictors of a prolonged ICU stay in HRF patients. Albumin levels of <3.25 g/dL and CCI scores of ?5 were linked to longer stays, with this combined evaluation offering greater predictive value. These factors can guide patient management. © 2024 by the authors.Öğe Neutrophil Percentage-to-Albumin Ratio as a Prognostic Marker in Pneumonia Patients Aged 80 and Above in Intensive Care(Mdpi, 2025) Ari, Maside; Solay, Asli Haykir; Ozdemir, Tarkan; Yildiz, Murat; Mentes, Oral; Tuten, Omer Faruk; Manav, Husra TetikBackground/Objectives: In recent years, inflammatory markers have been increasingly utilized to predict disease prognosis. The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a novel biomarker reflecting inflammation and systemic response. This study was conducted to evaluate the prognostic value of NPAR in pneumonia patients aged 80 years and older hospitalized in intensive care. Methods: Patients aged 80 years and older who were followed up in the intensive care unit with a diagnosis of pneumonia between 1 October 2022, and 31 May 2024, were retrospectively reviewed. Demographic characteristics, laboratory data, disease severity scores (APACHE II, SOFA), intensive care interventions, and variables associated with mortality were analyzed. NPAR was calculated by dividing the neutrophil percentage by the serum albumin level. The prognostic value of NPAR was assessed using Kaplan-Meier survival analysis, receiver operating characteristic (ROC) curve analysis, and Cox regression analysis. Results: A total of 135 patients were included in the study. Patients with NPAR > 0.286 had significantly higher SOFA (p = 0.002) and APACHE II (p = 0.007) scores. The high NPAR group was at significantly greater risk for requiring invasive mechanical ventilation (p = 0.003), vasopressor support (p = 0.042), and developing sepsis (p = 0.035). Elevated NPAR was strongly associated with mortality (p < 0.001) and was identified as an independent predictor of mortality in the Cox regression analysis (HR = 2.488, 95% CI: 1.167-5.302, p = 0.018). Conclusions: NPAR may serve as an effective biomarker for predicting disease severity and mortality risk in pneumonia patients aged 80 years and older. Due to its simplicity and accessibility, it can be considered a practical parameter for integration into clinical practice. However, large-scale, multicenter, and prospective studies are needed to validate these findings.Öğe Prediction of pulmonary intensive care unit readmissions with Stability and Workload Index for Transfer score(Kare Publ, 2023) Ertan, Ozlem; Celik, Deniz; Yildiz, Murat; Kurt, Hasret GizemBACKGROUND AND AIM: Readmission of patients discharged from the intensive care unit (ICU) to the ICU is common and increases mortality. The Stability and Workload Index for Trans-fer (SWIFT) score is a scoring system developed and validated to predict the risk of readmission to the ICU. We evaluated the usability of this scoring system in patients with respiratory failure in a pulmonary intensive care unit (PICU). METHODS: This study was a retrospective cross-sectional study that included patients hospi-talized in the PICU between January 1, 2020, and December 31, 2020. Patients who were dis-charged to the clinic or home and readmitted in the first 7-30 days were included in the study. Patients referred to an upper-level ICU or another hospital and those who died in the hospital were excluded from the study. RESULTS: A total of 442 patients received inpatient treatment during the study period, and 421 patients were included. Eight (1.9%) patients were readmitted within the first 7 days, and 25 (5.9%) patients were readmitted within 7-30 days. There was no significant difference between the SWIFT score, Acute Physiology and Chronic Health Evaluation II (APACHE II), and modified Charlson Comorbidity Index (mCCI) scores of the readmitted patients and those who were not. We calculated the area under the curve value for the SWIFT score as 0.548 (95% CI: 0.440-0.656). CONCLUSIONS: For patients discharged from the PICU, neither the SWIFT score nor APACHE II and mCCI were not sufficient to predict readmission. This study showed that existing scoring systems is insufficient to predict the readmission of patients with respiratory failure, and there is still a need for scoring systems to predict the readmission of these patients.Öğe The importance of uric acid levels in geriatric patients with respiratory failure under noninvasive mechanical ventilation in the respiratory intensive care unit(Bmc, 2025) Yildiz, Murat; Celik, Deniz; Ozdemir, Tarkan; Doganay, Guler Eraslan; Doganci, Melek; Cirik, Mustafa Ozgur; Ari, MasideIntroduction The respiratory system is critical for gas exchange, with respiratory failure resulting in insufficient oxygen and inadequate removal of carbon dioxide. Serum uric acid (SUA), a byproduct of purine metabolism, rises during hypoxemic conditions and has potential as a prognostic marker in respiratory failure. This study aimed to explore the relationship between SUA levels, mortality, duration of hospital stay, and ICU scores (APACHE II, and SOFA) in geriatric patients receiving non-invasive mechanical ventilation (NIV). Materials and methods We conducted a retrospective analysis of 1109 patients with respiratory failure admitted to the Respiratory Intensive Care Unit (RICU) from 2020 to 2022. We excluded minor patients (under 18 years old), patients with incomplete records, known gout, and dialysis-dependent or SRRT required renal failure. We collected demographics, comorbidities, laboratory findings, APACHE II, and SOFA scores. Patients were divided into two age groups (>= 65 and < 65). Statistical analysis, including chi-square, regression, and correlation tests, was performed to evaluate the association between SUA and clinical outcomes. Results Patients aged >= 65 had significantly higher SUA, creatinine, and BUN levels, as well as longer hospital stays and higher APACHE II and SOFA scores. Elevated SUA levels correlated with increased mortality and NIV requirements in the elderly. Regression analysis confirmed SUA as a predictor of NIV need. Discussion SUA levels are positively associated with worse outcomes in elderly patients with respiratory failure. This study supports previous research findings that hyperuricemia correlates with increased ICU admissions and mortality in respiratory conditions, particularly in older adults who need a noninvasive ventilation (NIV). Conclusion Elevated SUA levels are a valuable prognostic marker for predicting NIV needs and poor outcomes in geriatric patients with respiratory failure. Regular monitoring of SUA could enhance clinical management and improve prognosis in this population.Öğe The Influence of COPD Awareness on Hospital Admissions: A Paradoxical Relationship?(Mdpi, 2025) Celik, Deniz; Yildiz, Murat; Mentes, Oral; Yetkin, Ozkan; Lakadamyali, Huseyin; Gegin, Savas; Yurttas, AhmetBackground: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterised by frequent exacerbations, which contribute to increased healthcare utilisation and reduced quality of life. Knowledge about the disease is generally associated with better outcomes. This study examined the association between COPD knowledge levels and healthcare utilisation (including hospital readmissions) in patients hospitalised for acute exacerbations. Methods: This prospective observational study included 78 patients hospitalised for COPD exacerbations and classified as Group D according to the updated GOLD criteria 2021. The Bristol COPD Knowledge Questionnaire (BCKQ) was administered prior to discharge to evaluate patients' knowledge levels. Data were collected about emergency department visits, hospitalisations, and intensive care unit (ICU) admissions for a six-month follow-up period. Statistical analyses assessed the relationships between BCKQ scores, patient outcomes, and risk factors influencing hospital readmissions. Results: The median BCKQ total score was 23 (6-40). A strong correlation was found between higher BCKQ scores and more visits to the emergency room (p = 0.005), especially in the subdomains of epidemiology (p = 0.010), aetiology (p = 0.033), and dyspnoea (p = 0.042). Higher antibiotic knowledge scores were associated with ICU admissions (p = 0.019). Logistic regression analysis revealed that domiciliary NIV use (OR = 2.60, p = 0.041) and higher BCKQ scores (OR = 1.10, p = 0.010) were significant predictors of hospital readmissions. However, no significant relationship was found between survival and BCKQ or mCCI scores (p > 0.05). Conclusions: This study indicates that while increased COPD knowledge is associated with greater healthcare utilisation, it does not directly translate into improved clinical outcomes. These findings underscore the importance of integrating practical skills and behaviour management into educational programmes to help patients effectively apply their knowledge. Further research is needed to explore long-term implications and strategies to optimise knowledge-based interventions.
