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Introduction: It is important to know the risk factors for death in reducing mortality in patients with Stenotrophomonas maltophilia infections. The purpose of this study was to examine the risk factors associated with mortality in hospitalized patients with S. maltophilia infections. Material(s) and Method(s): Patients with S. maltophilia infections aged 18 years and older who were hospitalized in Haseki Research and Training between January 1, 2017, and April 30, 2022, were included in the study. The patients were divided into two groups, non-survivors and survivors, and the clinical features and laboratory parameters of the groups were compared. Mortality risk factors were analyzed by logistic and Cox regression analyses. Result(s): A total of 75 patients with S. maltophilia infections were included. The mortality rate was 38.6% (n= 29). Advanced age (OR= 1.05, 95% CI= 1.012-1.085, p= 0.009), COVID-19 pneumonia (OR= 9.52, 95% CI= 1.255-72.223, p= 0.029), and presence of central venous catheter (CVC) (OR= 18.25, 95% CI= 2.187-152.323, p= 0.007) were risk factors for death. Conclusion(s): Physicians should be aware of the potential risk of S. maltophilia infections for mortality, particularly in patients with predefined risk factors such as advanced age, the presence of CVC, and COVID-19. Performing CVC care in accordance with infection prevention and control measures and timely removal of CVC may be beneficial in reducing deaths due to S. maltophilia infection.Copyright © 2023 Bilimsel Tip Yayinevi. All rights reserved.
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Aim: To date, limited data exists on 1-year mortality and associated factors in patients with coronavirus diseases-2019 (COVID-19). We determined risk factors and predictors of 1-year mortality. Method(s): In this retrospective and single-center study, hospitalized patients with COVID-19 were enrolled between March 11 and March 11, 2020. The primary outcome was 1-year all-cause mortality after discharge from the hospital. Secondary outcomes were the risk factors and predictors of 1-year mortality. A comparative analysis was applied to patients who died after recovering from acute COVID-19 and patients who survived. Result(s): A total of 567 patients were analyzed. The 1-year mortality occurred in 18 (3.2%) patients. Older age (p=0.001), chronic obstructive pulmonary disease (p=0.001), chronic artery disease (p=0.001), chronic renal failure (p=0.001), presence of pleural fluid (p=0.001), high levels of leukocyte (p=0.001), neutrophil (p=0.001), monocyte (p=0.026), C-reactive protein (p=0.042), procalcitonin (p=0.004), urea (p=0.001), creatinine (p=0.001), troponin (p=0.001), lactate dehydrogenase (p=0.019), potassium (p=0.003), and a low level of alanine aminotransferase (p=0.001) at the first admission were associated with increased long-term mortality. Additionally, the need for intensive care unit (ICU) admission (p=0.007) and invasive ventilation (p=0.019) during the hospital stay for COVID-19 were associated with increased 1-year mortality. Conclusion(s): This study suggests that age, underlying diseases, pleural fluid, certain laboratory parameters, and ICU care are somewhat associated with 1-year mortality. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.
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Aim: Real-life data on the effect of coronavirus disease-2019 (COVID-19) vaccination is limited. We aimed to compare the incidence of COVID-19 among healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods during the COVID-19 pandemic and identify associated factors for COVID-19 development. Method(s): In this single-center and cross-sectional study, HCWs employed in a tertiary care hospital were included. Pre-vaccination (14 October, 2020 and 14 January, 2021) and post-vaccination periods (1 March, 2021 and 1 June, 2021) were compared. A subgroup analysis was performed on HCWs without a previous history of COVID-19. Additionally, univariate regression analysis of COVID-19 development in the post-vaccination period was performed. Result(s): Of 2,922 HCWs, 2,096 (71.7%) were vaccinated. The incidence of COVID-19 was higher in the pre-vaccination period (16.3%) than in the post-vaccination (6.6%) (p<0.01). In the subgroup analysis, the incidence of COVID-19 was 16.6% in the pre-vaccination period and 8.1% in the post-vaccination period (p<0.01). Previous history of COVID-19 (p<0.01) and double-dose vaccination (p<0.01) were associated with a decreased risk of COVID-19 development. Conclusion(s): This study demonstrates the real-life impact of COVID-19 vaccination in reducing disease development and preventing poor clinical outcomes in a setting where the vaccination rate among HCWs was fairly low. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.
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Background. We aimed to explore a novel risk score to predict mortality in hospitalised patients with COVID-19 pneumonia. In additoon, we compared the accuracy of the novel risk score with CURB-65, qSOFA and NEWS2 scores. Methods. The study was conducted in hospitalised patients with laboratory and radiologically confirmed COVID-19 pneumonia between November 1, 2020 and November 30, 2020. In this retrospective multicenter study. independent predictors were identified using multivariate logistic regression analysis. A receiver operating characteristics (ROC) analysis with area under the curve (AUC) was used to evaluate the performance of the novel score. The optimal cut-off points of the candidate variables were calculated by the Youden's index of ROC curve. Mortality was defined as all cause in-hospital death. Results. A total of 1013 patients with COVID-19 were included. The mean age was 60,5 ±14,4 years, and 581 (57,4%) patients were male. In-hospital death was occured in 124 (12,2%) patients. Multivariate analysis revealed that peripheral capillary oxygen saturation (SpO2), albumin, D-dimer, and age were independent predictors for mortality (Table). A novel scoring model was named as SAD-60 (SpO2, Albumin, D-dimer, ≥60 years old). SAD-60 score (0,776) had the highest AUC compared to CURB-65 (0,753), NEWS2 (0,686), and qSOFA (0,628) scores (Figure). Conclusion. We demonstrated that SAD-60 score had a promising predictive capacity for mortality in hospitalised patients with COVID-19. Univariate and multivariate analysis of factors predicting mortality Comparison of CURB-65, qSOFA, NEWS-2 and SAD-60 for predicting pneumonia mortality in hospitalised patients with COVID-19 by ROC analysis.
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NTRODUCTION: Anticoagulant treatment approach in patients with COVID-19 is not well studied and not standardized. We aimed to compare the effects of standard prophylactic and pre-emptive therapeutic Low-Molecular-weight Heparin (LMWH) treatment approaches on mortality in patients with COVID-19. PATIENTS AND METHODS: This retrospective and single-centre study includes patients aged ≥ 18 years, who were diagnosed with COVID-19 and treated with LMWH during the hospital stay. Therapeutic dose of LMWH was defined as 1 mg/kg subcutaneously twice daily and prophylactic dose of LMWH was defined as 40 mg subcutaneously once daily. RESULTS: Among the 336 patients diagnosed with COVID-19 pneumonia, 115 patients, who received LMWH were included in the study. The mean age was 58.6 ± 13.3 and 58 (50.4 %) of the patients were male. Sixty-nine (60 %) of the patients were treated with prophylactic and 46 (40 %) therapeutic LMWH.In-hospital mortality was not different between patients treated therapeutic LMWH and prophylactic LMWH by the multivariate regression analysis (OR=2.187, 95% CI 0.484-9.880, p=0.309) and the propensity score modelling (OR=1.586, 95% CI 0.400-6.289, p=0.512.)CONCLUSION: Clinicians should consider the potential risks and benefits of standard prophylactic and pre-emptive therapeutic LMWH. Therefore, anticoagulant therapy should be individualized in patients with COVID-19 (Tab. 3, Ref. 28).