Yazar "Korkmaz, Ufuk Turan Kürşat" seçeneğine göre listele
Listeleniyor 1 - 15 / 15
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Aortic knob width as a novel predictor of postoperative atrial fibrillation following off-pump coronary artery bypass grafting(2021) Korkmaz, Ufuk Turan Kürşat; Uçaroğlu, Erhan RenanThe aim of this study was to determine whether aortic knob width (AKW) was related to the development of postoperative atrial fibrillation (AF) in patients undergoing off-pump coronary artery bypass grafting (CABG). Between July 2017 and June 2019, a total of 453 patients undergoing isolated off-pump CABG were enrolled to this retrospective observational cohort study. The patients were divided into two groups; as AF group (n=102) and non-AF group (n=351). The groups were compared with regard to preoperative demographics and clinical characteristics, intraoperative data, and postoperative outcomes, and then a multivariate logistic regression analysis was performed in order to determine the independent predictors of postoperative AF. The incidence of postoperative AF in our study population was found as 22.5% (n=102/453). The median age and AKW, and the frequencies of hypertension and chronic renal dysfunction were significantly higher in patients in AF group than in non- AF group. Multivariate logistic regression analysis revealed that age and AKW were the independent predictors of postoperative AF. The analysis yielded that the risk of POAF development increased by 5.2% with each one-year increase in patient age [OR 1.0520 with 95% CI= (1.0214, 1.0835), p<0.001], and by 3.36 times when AKW increased by 1 cm [OR 3.3614 with 95% CI= (2.6142, 4.3961), p<0.001]. ROC analysis revealed that AKW of 43.9 mm constituted the cut-off value for the development of AF with 68.6% sensitivity and 80.9% specificity. The present study demonstrated that AKW was a significant and independent predictor of AF following off-pump CABG.Öğe Association between vitamin D levels and lower-extremity deep vein thrombosis: A case-control study(ASSOCIACAO PAULISTA MEDICINA, 2021) Korkmaz, Ufuk Turan Kürşat; Ersoy, Süleyman; Yüksel, Ahmet; Çelik, Hümeyra; Uçaroğlu, Erhan RenanBACKGROUND: Vitamin D has relationships with pathogenesis and inflammation pathways in many diseases. Its deficiency may make clinicians think not only of supplementation but also of presence of other diseases. OBJECTIVE: To investigate the relationship between vitamin D levels and deep vein thrombosis (DVT), given that reduced levels are related to increased risk of cardiovascular diseases. DESIGN AND SETTING: Case-control study conducted in the cardiovascular surgery and family medicine departments of a hospital in Turkey. METHODS: A total of 280 participants were included: 140 each in the DVT and control groups. Basic clinical characteristics, comorbidities and serum 25-hydroxyvitamin D (25(OH)D) levels were recorded and then compared between the groups. Serum 25(OH)D levels were also evaluated separately in three subgroups (sufficient, insufficient and deficient). RESULTS: Serum 25(OH)D levels were significantly lower in the DVT group than in the controls (P < 0.001). Females in the DVT group had lower 25(OH)D levels than those in the control group (P = 0.002). Nonetheless, the median 25(OH)D level (16.41 ng/ml) of the control group was still below the reference value. Logistic regression analysis showed that 25(OH)D was a significant predictor of DVT. Weight, height and body mass index, which all presented interaction, were significant in the logistic regression analysis but not in individual analyses. CONCLUSION: The serum vitamin D levels of DVT patients were lower than those of controls. If the results obtained from our study are supported by further large-scale randomized controlled trials, vitamin D replacement may be brought into the agenda for protection against DVT.Öğe Catheter Malposition as a Considerable Complication of Central Venous Catheterization: An Analysis of 23 Cases in a Tertiary Referral Hospital(2021) Korkmaz, Ufuk Turan Kürşat; Uçaroğlu, Erhan RenanObjectives: We aimed to present the clinical characteristics of patients with catheter malposition following central venous catheterization, and to review the relevant literature. Materials and Methods: A total of 1816 patients who underwent central venous catheterization via internal jugular or subclavian vein in a tertiary referral hospital between January 2011 and December 2018 were researched for this cross-sectional study. Among them, procedure-related catheter malposition was detected in 23 cases, and the study population composed of these cases with catheter malposition. Medical data of study population were obtained and retrospectively reviewed. Results: The rate of catheter malposition following central venous catheterization was 1.26%. The mean age of the study population was 55.1±21.3 years, and 52.2% of them were male. The blind-landmark technique without ultrasound guidance was the selected approach in 21 of cases (91.3%). In study population, additional procedure-related complications were subcutaneous hematoma, pneumothorax, and hemo-pneumothorax in six, three and two cases, respectively. In-hospital death was observed in two cases because of the causes other than procedure-related complications. Conclusion: Catheter malposition is a relatively lesser encountered but an important complication of central venous catheterization. We suggest that during central venous catheterization, the radiological-guided approach should be of choice instead of the blind-landmark technique to minimize the risk of catheter malposition.Öğe The Correlation of C-Reactive Protein/Albumin, Mii-1 and Mii-2 Indexes With Hospitalization and Mortality in Stanford Type A Aortic Dissection(2022) Demirel, Mustafa Enes; Korkmaz, Ufuk Turan Kürşat; Donmez, Ibrahim; Özçelik, Ayşenur; Korkmaz, AbdullahAim: In this study we aimed to investigate the relationship between C-Reactive Protein (CRP)/albumin ratio, MII-1 and MII-2 indexes in hospitalization and mortality due to aortic dissection. Material and Method: Patients who presented to our emergency department with a sudden-onset, sharp and stabbing chest pain and diagnosed with Stanford type A aortic dissection were included in the study. Patients’ demographics such as age and gender, hemogram parameters, ratios, indexes, hospitalization and mortality status were recorded. Demographic features, hemogram parameters, ratios and indexes were compared between the survivor and exitus patients. Results: A total of 71 patients who presented to the emergency department with sudden-onset stabbing chest pain and subsequently diagnosed with aortic dissection were included in this retrospective study. The median age of the patients was negatively correlated with albumin (r=-0.27, p=0.021), hemoglobin (r=-0.28, p=0.019). Hemoglobin values were significantly higher in male than in female patients. The median length of stay in the hospital was found as 10 (7-14) days. In the correlation analysis of the hemogram parameters, indexes and length of stay in the hospital; CRP and CRP/Albumin ratio were significantly correlated with length of stay in the hospital in positive direction. Conclusion: The results of this study point out a significant correlation between CRP, CRP/albumin ratio and length of stay in hospital. This information might be helpful in rapid decision making process for early diagnosis and treatment of the disease.Öğe Development of venous thromboembolism in patients with hereditary thrombophilic risk factors and evaluation of genetic and biochemical parameters affecting development of venous thromboembolism(2020) Korkmaz, Ufuk Turan Kürşat; Çetinkaya, Ayhan; Yüksel, Ahmet; Velioğlu, Yusuf; Uçaroğlu, Erhan Renan; Arslan, Ali Osman; Erdem, KemalettinObjectives: To evaluate patients diagnosed with venous thromboembolism (VTE) in terms of hereditary thrombophilic risk factors and to assess genetic and biochemical factors affecting the development of VTE. Methods: Sixty patients with VTE and 23 control subjects without VTE were retrospectively evaluated. Prevalence of thrombophilic risk factors and parameters like demographic data, clinical follow-up duration were examined with genetic, biochemical and radiological investigations. Results: Mutations were detected in the genes of Factor V Leiden in 37.4%, Factor II in 13.4%, Methylenetetrahydrofolate reductase C677 in 47.5%, Methylenetetrahydrofolate reductase A1298C in 53.3%, Plasminogen activator inhibitor-1 in 31.6%, Angiotensin converting enzyme in 39.0%, and Factor V H1299R in 8.3% of patients. Protein C deficiency was detected in 25 patients (41.7%), free Protein S deficiency was detected in 25 patients (41.7%) in study group and 3 subjects (13.0%) in control group, and this difference was statistically significant (p=0.023). Antithrombin III deficiency was detected in 1 patient (1.7%) in study group. Elevated homocysteine was higher in study group compared to controls, and the difference was statistically significant (p=0.02). Conclusion: Determination of hereditary risk factors in VTE patients will provide family members who have hereditary risk factors, but did not suffer attack to be protected against thromboembolic attacks by taking simple measures against acquired factors.Öğe Does pulmonary hypertension affect early-term outcomes of off-pump coronary artery bypass surgery?(Assoc Medica Brasileira, 2022) Velioğlu, Yusuf; Yüksel, Ahmet; Topal, Dursun; Korkmaz, Ufuk Turan Kürşat; Dönmez, İbrahim; Badem, Serdar; Uçaroğlu, Erhan RenanOBJECTIVE: This study aimed to investigate the effect of preoperative pulmonary hypertension (PHT) on postoperative early mortality and morbidity in patients undergoing off-pump coronary artery bypass grafting (CABG).METHODS: A total of 1107 patients undergoing elective first-time off-pump CABG between January 2011 and April 2022 were included in this retrospective observational cohort study. The patients were categorized into two groups according to their preoperative systolic pulmonary artery pressure (SPAP) values. The PHT group (n=104) consisted of patients with a SPAP value >30 mmHg, while the non-PHT group (n=1003) consisted of patients with a SPAP value <= 30 mmHg. Patients' preoperative demographics and clinical features, operative data, and postoperative outcomes were recorded and then compared between the groups.RESULTS: In the PHT group, the median age was significantly higher (66 vs. 63 years, p=0.001) and the median left ventricular ejection fraction level was significantly lower (45 vs. 50%, p=0.045) as compared to the non-PHT group. Additionally, the PHT group included a significantly greater percentage of patients with chronic obstructive pulmonary disease (22.1 vs. 7.4%, p=0.019). As perioperative early-term outcomes, complications, and mortality were considered, the groups were statistically similar, and there were no significant differences between the groups, except for the development of atrial fibrillation.CONCLUSION: For the first time in the literature, this study revealed that mild PHT (mean SPAP=38.9 +/- 8.7 mmHg) did not significantly affect early -term outcomes of off-pump CABG.Öğe Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease(Sage Publications Ltd, 2021) Korkmaz, Ufuk Turan Kürşat; Yüksel, Ahmet; Çetinkaya, Ayhan; Velioğlu, Yusuf; Uçaroğlu, Erhan Renan; Erdem, KemalettinObjective To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. Methods One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case-control study. Participants' baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. Results Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group (p = 0.045,p = 0.000 andp = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group (p = 0.000,p = 0.000 andp = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. Conclusion Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.Öğe Evaluation of Pathogens Isolated from Central Venous Catheters Used for Cardiovascular Interventions(2021) Korkmaz, Ufuk Turan Kürşat; Gülhan, BarışObjective: To evaluate the isolated pathogens in patients who underwent central venous catheterization due to cardiovascular procedures. Materials and Methods: Patients were monitored daily for the development of catheter related infections. Between April 2017 and July 2019, patients who exhibited infection symptoms like discharge, fever, pain, lymphadenopathy and itching after the catheterization were included in this retrospective study. Patients’ catheter types, catheter insertion sites, total catheterization durations, culture results, sensitivities and resistances of pathogens against antimicrobial drugs were recorded and analyzed.Results: Eighty-six patients who underwent central venous catheterization due to various indications were included. Mean age of patients was 52.70±17.82 years. Bacterial growth was found in 62.79% of patients. The most common catheter insertion sites were right subclavian vein, right jugular vein and right femoral vein. The most commonly isolated microorganism was S. aureus by 25.58% followed by E.coli (6.98%), S. haemolyticus (5.81%) and K.pneumonia (5.81%). S. aureus was detected to be sensitive to vancomycin and linezolid. Conclusion: Factors affecting incidence of these infections include catheter insertion site, catheterization duration, catheter selection and skills of the practitioners. Data in literature about the pathogens isolated in catheter-related infections and their sensitivity and resistance to antimicrobial agents are mostly old. Further comprehensive, multicenter studies are needed on this issue.Öğe Images in vascular medicine: Sudden mental status change and speech disturbance due to aortic echinococcosis(SAGE Publications Ltd, 2023) Uçaroğlu, Erhan Renan; Gözdaş, Hasan Tahsin; Yılmazsoy, Yunus; Özçelik, Hüsna; Korkmaz, Ufuk Turan Kürşat; Erdem, KemalettinA 52-year-old man presented to our center with speech disorder which occurred after temporary loss of consciousness that lasted nearly 10 seconds and was repeated twice. He had a history of cerebrovascular event nearly 2 months ago. He was conscious and had no acute distress.Öğe A novel modified technique with a combination of percutaneous embolization with n-butyl cyanoacrylate and high ligation of saphenous vein: A preliminary report(Springer India, 2020) Uçaroğlu, Erhan Renan; Korkmaz, Ufuk Turan Kürşat; Yüksel, Ahmet; Velioğlu, Yusuf; Ünal, Osman; Erdem, KemalettinChronic venous insufficiency (CVI) is defined as a condition affecting the venous system of lower extremities. Different treatment options are used for the treatment of this pathological condition, which impairs quality of life, especially in later stages. Surgical options are used in the case of failure with conservative treatment and pharmacological methods. There are numerous surgical techniques used in the treatment of venous insufficiency. Each of these techniques has its advantages and disadvantages. New hybrid methods are being developed to overcome adverse effects and possible complications such as deep vein thrombosis, phlebitis, and infections. In the present study, we aimed to present the preliminary results of a combination of percutaneous embolization of SV with n-butyl cyanoacrylate (NBCA) and high ligation, which is a novel modified method that we have developed. A total of 47 patients, aged between 28 and 62 years and diagnosed with chronic venous insufficiency, were included in the study. The patients were evaluated with a Comprehensive Classification System For Chronic Venous Disorders, and Venous Clinical Severity Score (VCSS). Patients' demographic features such as age and gender, and clinical features such as CEAP classes, VCSSs, and vena saphena magna VSM diameters were recorded. All patients were treated with a novel modified hybrid technique including Venablock embolization system (Invamed RD, Ankara, Turkey) and surgical high ligation of the greater SV. In addition, patients' preprocedural, intraprocedural, and postprocedural period follow-up data were recorded and retrospectively analyzed. According to the CEAP classification, 38 patients (80.8%) were classified as C3, six patients (12.8%) as C4, and three patients (6.4%) as C2. CEAP class was C3 in majority (38/47) of the patients, with 22 (46.8%) female and 22 (53.2%) male patients in C3 class. The mean preoperative VCSS of the patients was calculated as 8.83 +/- 1.31 and the mean postoperative VCSS was calculated as 2.85 +/- 0.71. The mean postoperative VCSS was statistically significantly lower than the mean preoperative VCSS (p < 0.05). The technical success rate was found as 100%. None of the patients developed complications or side effects. We suggest that this novel method is efficient and safe in the treatment of chronic venous insufficiency because it eliminates the need for general anesthesia with short operation time and adhesion of all branches of the saphenous vein, thus preventing possible complications.Öğe Novel oral anticoagulants’ efficacy and safety in comparison to vitamin K antagonists and low molecular weight heparins(2023) Demirel, Mustafa Enes; Korkmaz, Ufuk Turan KürşatObjective: The last standard treatment for venous thromboembolism (VTE) is oral anticoagulation with a vitamin K antagonist. Treatment with a vitamin K antagonist requires frequent monitoring of the international normalized ratio (INR), and these drugs have several disadvantages. Direct oral anticoagulants are alternative drugs to oral antivitamin K anticoagulants. With safer ranges, novel oral anticoagulants (NOACs) have been accepted in guidelines as drugs of choice. This study aimed to retrospectively examine the outcomes of three new-generation anticoagulant drugs in a patient group. Methods: Two hundred eighteen adults were included in this retrospective cohort study. Patients are included in this study if they had been used any of these drugs in the past: Warfarin, low molecular weight heparin (LMWH), dabigatran, apixaban, and rivaroxaban. The study was conducted retrospectively for evaluating safety and effectiveness. Treatment charges for LMWH, warfarin, and NOAC were calculated based on info from the medical monitoring fee, approximate hospital transportation costs per INR measurement, and drug fees for 6 months. Results: In comparison with warfarin (n: 1, 1.4%), the risk of embolism recurrence was found higher with apixaban (n: 6, 20%, RR: 14.4, OR: 17.75, 95% CI: 2.03-154.99, p=0.002) and rivaroxaban (n: 6, 19.4%, RR: 13.94, OR: 17.04, 95% CI: 1.95-148.57, p=0.003) in patient groups. Conclusion: Compared to the literature, the rivaroxaban and apixaban groups had greater bleeding and recurrence risk in our study. This may be due to dietary habits and genetic factors.Öğe Systemic immune-inflammation index as a novel predictor of atrial fibrillation after off-pump coronary artery bypass grafting(Assoc Medica Brasileira, 2022) Topal, Dursun; Korkmaz, Ufuk Turan Kürşat; Velioglu, Yusuf; Dönmez, İbrahim; Uçaroğlu, Erhan Renan; Kayış, Seyit Ali; Yüksel, AhmetOBJECTIVE: This study aims to examine the predictive role of systemic immune-inflammation index on postoperative new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting. METHODS: A total of 722 patients undergoing elective off-pump coronary artery bypass grafting between January 2017 and September 2021 were included in this study and divided into two groups as the atrial fibrillation group (n=172) and the non-atrial fibrillation group (n=550). Both groups were compared in terms of patients' baseline clinical features, operative and postoperative variables, and preoperative hematological indices derived from the complete blood count analysis. Multivariate logistic regression and receiver-operating characteristic curve analyses were performed to detect the independent predictors of postoperative new-onset atrial fibrillation. RESULTS: The median age and length of hospital stay in the atrial fibrillation group were significantly higher than those in the non-atrial fibrillation group. The median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune -inflammation in the atrial fibrillation group were significantly greater than in those in the non-atrial fibrillation group. Logistic regression analysis demonstrated that age, platelet, platelet/lymphocyte ratio, and systemic immune-inflammation were independent predictors of postoperative new -onset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7x103/mm3 constituted cut-off value to predict the occurrence of new-onset atrial fibrillation with 86.6% sensitivity and 29.3% specificity. CONCLUSION: Our study revealed for the first time that systemic immune-inflammation predicted new-onset atrial fibrillation after off-pump coronary artery bypass grafting.Öğe Systemic immune-inflammation index for predicting poor outcome after carotid endarterectomy: A novel hematological marker(Sage Publications Ltd, 2022) Yüksel, Ahmet; Velioğlu, Yusuf; Korkmaz, Ufuk Turan Kürşat; Deşer, Serkan Burç; Topal, Dursun; Uçaroğlu, Erhan RenanObjective To investigate the predictive role of systemic immune-inflammation index (SII) on postoperative poor outcome in patients undergoing carotid endarterectomy (CEA). Methods A total of 347 patients undergoing elective isolated CEA between March 2010 and April 2022 were included in this multicenter retrospective observational cohort and risk-prediction study and were divided into two groups as poor outcome group (n = 23) and favorable outcome group (n = 324). Poor outcome was defined as the presence of at least one of the complications within 30 days of surgery including stroke, myocardial infarction, and death. The patients' baseline clinical characteristics, comorbidities, and hematological indices were derived from the complete blood count (CBC) analysis, and perioperative data, outcomes, and complications were screened, recorded, and then compared between the groups. Multivariate logistic regression and receiver-operating characteristic (ROC) curve analyses were conducted following univariate analyses to detect the independent predictors of poor outcome as well as the cutoff values with sensitivity and specificity rates. Results A total of 23 patients out of 347 (6.6%) manifested poor outcome; and stroke, myocardial infarction, and death occurred in 13, 3, and 7 cases, respectively. There were no significant differences between the groups in terms of basic clinical characteristics, comorbidities, and perioperative data, except for lengths of intensive care unit and hospital stays. Although the median values of PLT, PLR, NLR, and SII of the poor outcome group were found to be significantly higher than the favorable outcome group in univariate analysis, only SII was detected to be a significant and independent predictor of poor outcome in multivariate logistic regression analysis (OR = 1.0008; 95% CI: 1.0004-1.0012; p = 0.002). ROC curve analysis revealed that SII of 1356 x 10(3)/mm(3) constituted the cutoff value for predicting poor outcome with 78.3% sensitivity and 64.5% specificity (AUC = 0.746; 95% CI: 0.64-0.851). Conclusions Our study revealed for the first time in the literature that SII significantly predicted poor outcome after CEA. KeywordsÖğe Ultrastructural examination of left internal mammary artery under electron microscopy in patients with chronic kidney disease who underwent coronary bypass surgery(2020) Uçaroğlu, Erhan Renan; Korkmaz, Ufuk Turan Kürşat; Yüksel, Ahmet; Velioğlu, Yusuf; Aldemir, Mustafa; Erdem, KemalettinAim: To investigate the vascular damage of internal mammary artery graft with electron microscope secondary to chronic renal failure transmission in patients who underwent coronary artery bypass grafting surgery. Method: A total of 30 patients (10 patients with chronic renal failure and 20 patients without chronic renal failure) who underwent coronary artery bypass graft surgery were included in this prospective study. Left internal mammary artery graft was harvested as conventional fashion with no touch technique. Samples were prepared and then examined with the transmission electron microscope. Every arterial sample was individually examined ultrastructurally, and the changes were recorded. Then the samples of the control group and chronic renal failure group were compared. Results: There were no significant differences between chronic renal failure group and the control group in terms of demographics, comorbidities, intraoperative data and postoperative outcomes, and the groups were statistically similar (p<0.05). Moreover, no statistically significance was detected in terms of structure and ultrastructure between the groups. Conclusion: The results of our study revealed that no ultrastructural changes were observed in the structure of IMA, suggesting that this graft would provide a good graft patency.Öğe Venöz trombo emboli (VTE) tanılı herediter trombofilik risk faktörleri taşıyan hastaların klinik, radyolojik, biyokimyasaltrombofili takip tetkiklerinin ve diğer parametrelerinin tedavi planı ve takibine etkilerinin karşılaştırılması(Bolu Abant İzzet Baysal Üniversitesi, 2013) Korkmaz, Ufuk Turan Kürşat; Dağlar, BahadırVenöz tromboemboli (VTE) günümüzde hala önemli bir mortalite ve morbidite nedenidir. VTE etyolojisinde birçok kalıtsal ve edinsel faktör rol oynar. Kalıtsal faktörler VTE? ye yatkınlık oluşturmakta, genç yaşta başlayıp tekrarlama eğilimi göstermektedir. Bu nedenle VTE hastalarında, kalıtsal trombofilik etkenlerin taranması, tedavi ve takip planı açısından önem arz etmektedir. Bu tez çalışmasında Abant İzzet Baysal Üniversitesi Sağlık Uygulama ve Araştırma Merkezinde 60'ı (%72,3) VTE tanısı konulan çalışma gurubu ve 23'ü (%27,7) VTE tanısı olmayan kontrol gurubundan oluşan toplam 83 hastada retrospektif olarak Faktör V G1691A [ Faktör V Leiden (FVL) ], Faktör V H 1299 R, Protrombin G20210A (Faktör II), Metilentetrahidrofolat redüktaz C677T (MTHFR C677T), Metilentetrahidrofolat redüktaz A1298C (MTHFR A1298C), Plazminojen aktivatör inhibitör-1 (PAI-1), Anjiyotensin converting enzim (ACE) gen mutasyonları ile Protein C (PC), serbest Protein S (PS), Antitrombin III (AT III) ve homosistein gibi trombofilik faktörlerin sıklığını saptamayı ve bu faktörler ile hastaların demografik, klinik, radyolojik, gelişim şekilleri pulmoner emboli (PE), kanser birlikteliği, tekrarlama ve takip süresi gibi parametrelerlerinin tedavi planı ve hasta takibine etkilerinin karşılaştırılmasını amaçladık. Tanı, tedavi ve takibi merkezimizde yapılmamış ve/veya yukarıdaki faktörlere uygun şekilde ve zamanda bakılmamış hastalar çalışma dışında bırakıldı. İstatistiksel analiz SPSS 15.0 programı ile T testi, Ki-kare testi, Mann-Whitney U Testi, Kruskal-Wallis Testi, Oneway anova testi, Post Hoc Testleri, Factor Analysis testleri kullanılarak yapıldı. Çalışmamızda VTE gelişen hastaların 25?i erkek (41,7), 35'i kadın (58,3) idi. Sonuç olarak çalışma grubundakilerin %37,4?ünde FVL, %13,4?ünde Faktör II, %47,5?inde MTHFR C677, %53,3?ünde MTHFR A1298C, %31,6?sında PAI-1, %39,0 ?un da ACE, %8,3?ünde Faktör V H1299R geninde mutasyon saptandı. Faktör V H1299R mutasyonun varlığı açısından çalışma grubu cinsiyete göre değerlendirildiğinde kadınlarda bu oran %14,3 iken, erkeklerde mutasyon saptandı ve bu durum istatistiksel olarak anlamlıydı (Ki-kare p=0,048). PC eksikliği 25 olguda (% 41,7), serbest PS eksikliği çalışma grubunda 25 olguda (% 41,7) ve kontrol grubunda 3 olguda (% 13,0) saptandı ve bu durum istatistiksel olarak anlamlıydı (Ki-kare p=0,023). Çalışma grubunda AT III eksikliği 1 olguda (% 1,7) tespit edildi. Çalışma grubunda 18?i kadın (% 51,4) ve 25?i erkek (% 100,0) olmak üzere toplam 43 olguda (% 71,7), kontrol grubunda ise 3?ü kadın (% 20,0) ve 5?i erkek (% 62,5) olmak üzere toplam 8 olguda (% 34,8) homosistein yüksekliği saptandı. Çalışma grubunda homosistein yüksekliği kontrol gurubuna göre daha fazla idi. Aradaki fark istatistiksel olarak anlamlıydı (Ki-kare p=0,02). Çalışma grubunda homosistein yüksekliği erkeklerde kadınlara göre daha fazla görülmektedir bu durum istatistiksel olarak anlamlıdır (Ki-kare p 0,001). Kontrol grubunda da homosistein yüksekliği erkeklerde kadınlara göre daha fazla görülmekte olup bu durum istatistiksel olarak anlamlı bulunmuştur (Ki-kare p=0,042). Çalışılan toplam 83 hasta göz önüne alındığında da kadın erkek cinsiyeti arasında homosistein yüksekliği açısından istatiksel olarak anlamlı fark bulunmuştur (Ki-kare p 0,003). Çalışma grubunda 2 olguda (%3,3) bilateral alt ekstremitede, 24 olguda (%40,0) sağ alt ekstremitede ve 34 olguda (%56,7) sol alt ekstremitede bir veya daha fazla derin vende trombüs gözlenirken bunlardan 51 vakada (%85,0) Popliteal vende, 33 vakada (%55,0) Yüzeyel femoral vende, 29 vakada (%48,3) Ana femoral vende, 22 vakada (%36,7) Derin femoral vende trombüs tespit edildi. VTE gelişen 8?i kadın (%22,9), 1?i erkek (%4,0) toplam 9 olguda (%15,0) PE görülmüş ve cinsiye göre VTE olgularında PE gelişimi karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmıştır (Ki-kare p=0,044). VTE gelişen 10 olguda (%16,7) kanser birlikteliği ve 16 olguda (%26,7) VTE?nin tekrarladığı tespit edildi. Kontrol grubunda ise 1 (%4.3) olguda yüzeyel trombo filebitte (YTF) tekrarlama görülmüş ve çalışma ve kontrol grupları arasında tekrarlamada istatistiksel olarak anlamlı fark saptanmıştır ( Ki-kare p=0.024). 24 olguda (%40,0) VTE gelişiminin spontan olduğu gözlendi. 17?si kadın (%48,6) ve 7?si erkek (%28,0) olmak üzere toplam 24 olguda (%40,0) VTE gelişiminin yatarak tedavi görme ile ilişkili olduğu görüldü. Yatarak tedavi görme ile ilişkili VTE gelişimi çalışma gurubunda kadınlarda erkeklere göre daha fazla idi bu fark istatistiksel olarak anlamlı bulundu (t test p=0,020). 7 olguda (%11,7) VTE gelişiminin uzun yolculuk hikayesi ile ilişkili olduğu görülürken 5 olguda (%8,33) VTE gelişiminin gebelik ile ilişkili olduğu tespit edildi. Gelişim şekilleri ile herediter trombofili nedenlerinin görülme sıklığı karşılaştırıldığında : FVL geninde mutasyon görülme sıklığı VTE gelişiminin spontan olduğu olgularda uzun yolculuk ile ilişkili olduğu olgulara göre daha fazla tespit edildi. aradaki fark istatistiksel olarak anlamlı idi (Scheffe p=0,004 ve Games-Howel p=0,037). ACE geninde mutasyon görülme sıklığı VTE gelişiminin yatarak tedavi görme ile ilişkili olduğu olgularda uzun yolculuk ile ilişkili olduğu olgulara göre daha fazla idi. Aradaki fark istatistiksel olarak anlamlı idi (Games-Howel p=0,038). Serbest PS eksikliği ise VTE gelişiminin spontan olduğu olgularda yatarak tedavi görme ile ilişkili olduğu olgulara göre daha fazla idi. Aradaki fark istatistiksel olarak anlamlı idi (Scheffe p=0,001). Anahtar Kelimeler: Herediter trombofili, venöz tromboemboli, yüzeyel trombofilebit.
