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    Comparison of Nursing Home-acquired Pneumonia and Community-acquired Pneumonia and Evaluation of Factors Predicting Mortality
    (Erciyes Univ Sch Medicine, 2022) Yencilek, Halil Ilker; Sener, Alp; Ozhasenekler, Ayhan; Ergin, Mehmet; Gunaydin, Gul Pamukcu; Gokhan, Servan; Ere, Ozcan
    Objective: The number of admissions to the emergency department (ED) of elderly patients who reside in nursing homes with a diagnosis of pneumonia continues to grow. This study was designed to assess factors that predicted mortality in the patient group defined as those with nursing home-acquired pneumonia (NHAP). Materials and Methods: This was a prospective, observational study conducted in a hospital ED. The data of nursing home patients admitted to the ED with a pneumonia presentation (NHAP) were compared with those of patients with community-acquired pneumonia (CAP). Factors that predicted mortality in the NHAP group were analyzed. SPSS for Windows, Version 16.0 software (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analysis. Results: A total of 98 patients >18 years of age, 36 of whom were NHAP patients, were included in the research. The risk level and rates of intensive care admission and mortality were significantly higher in the NHAP group (p<0.05), and the thiol level, an antioxidant parameter, was lower in the NHAP group than that of the CAP group (p<0.001). Evaluation of the NHAP group alone revealed a higher mortality rate in patients with congestive heart failure, those hospitalized in intensive care, and those with high risk scores (p<0.05). The shock index (SI) value was found to be an independent predictor of mortality in the NHAP group. The study results indicated that each 0.1 unit increase in the Si increased mortality 3.637 times (95% confidence interval: 1.024-12.921) (p=0.046). Conclusion: The findings suggest that the SI could serve as a valuable marker for predicting mortality in NHAP patients.
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    Prognostic value of the nr2 peptide in patients underwent cardiopulmonary resuscitation
    (Carbone Editore, 2019) Çolak, Tamer; Koçak, Sedat; Dündar, Zerrin Defne; Ergin, Mehmet; Girişgin, Abdullah Sadık; Cander, Başar; Gül, Mehmet
    Introduction: The studies carried out in recent years have shown that N-methyl-D-aspartate receptor subunit antibodies (NR2ab) are plasma biomarkers for acute cerebral ischemia. The aim of this study was to investigate the relationship between serum NR2ab levels and the survival and prognosis of the patients undergoing Cardiopulmonary Resuscitation (CPR). Method: This research is a prospective observational study. Our study included 91 patients undergoing CPR in the Emergency Department of Meram Faculty of Medicine at Necmettin Erbakan University between 10/2014 and 06/2015. Traumatic and non-traumatic arrests were accepted as cardiac arrest etiology. Demographic data, chronic illnesses andarrest locations of the patients were recorded. NR2-ab levels were measured through the analysis of serum samples taken from the patients during CPR. Antibody values of the patients who achieved ROSC and the patients losing their lives were compared. NR2-ab values of the patients who were alive on the 28th day were compared with the antibody values of the patients who died. The Glasgow Coma Scale (GCS) of the patients who achieved ROSC and who were still alive was recorded at the 24th hour, on the 7th day and on the 28th day. The modified Rankin Scale (MRS) and Glasgow Outcome Scale (GOS) of the surviving patients were also recorded on the 28th day. In conclusion, it was aimed to investigate the relationship between NR2-ab levels of the patients undergoing CPR and their survival and prognosis rates. Findings: The study was carried out on 91 patients. The average age of the patients was 63,6 +/- 17,6, and 64,8% of the group were male. Pre-hospital arrests were recorded in 56,0% of the patients while 44,0% of the patients developed arrests in the hospital. When the causes of arrests were taken into consideration, it was seen that 86.8% of the arrests resulted from medical factors, and that 13.2% of the arrests were caused by traumas. 60.4% of the patients achieved ROSC. A statistically significant difference was found in terms of NR2-ab levels between the patients achieving ROSC and those losing their lives (p = 0.004). Although there was a numerical difference between the NR2-ab value of the patients who were still alive on the 28th day and the NR2-ab value of those losing their lives, there was no statistically significant difference (p = 0.075). On the other hand, when the relationship between NR2ab values and neurological prognosis was analyzed, no significant correlation was found between GCS values at the 24th hour and GCS, GOS and MRS values on the 28th day. Conclusion: Today, there is no method that is valid and effective on its own to follow up the success of CPR after Cardiopulmonary Arrest (CPA) and to evaluate the survival rates and prognosis of the patients. We found in our study that NR2-ab was a significant biomarker for the evaluation of the survival rates.