Aim: This study aims to analyze the incidence of multidrug-resistant (MDR) retrospectively and extensively drug-resistant (XDR) infections, characteristics of patients with these infections, causative microorganisms, and mortality rates in a tertiary respiratory intensive care unit (ICU). Material and Method: Between 01.01.2022 and 31.12.2023, the data of patients treated in the third-level respiratory ICU were analyzed retrospectively. Adult patients over 18 years of age with MDR and XDR infections were included in the study. Demographic characteristics, age, gender, comorbid systemic diseases, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, mechanical ventilation support status, duration of ICU stay and prognosis of the patients were analyzed and recorded through the hospital information management system. Results: The study included 261 patients. Of these patients, 184 (70.5%) were male, 77 (29.5%) were female, and their ages were 65.54 ± 14.43 years. The majority of the patients had chronic diseases such as chronic obstructive pulmonary disease, hypertension, coronary artery disease, malignancy, and diabetes mellitus. There was no statistically significant difference between the resistance status of Klebsiella spp. Pseudomonas spp. and Acinetobacter spp. and the prognosis of the patients (p> 0.05). No statistically significant difference was found between MDR and XDR Klebsiella spp. Pseudomonas spp. and Acinetobacter spp. patients in terms of the need for invasive mechanical ventilation, non-invasive mechanical ventilation, respiratory support therapy with high flow, APACHE II score, SOFA score, length of stay in the ICU, and prognosis (p> 0.05). Conclusion: Early detection and close monitoring of MDR, XDR, and PDR bacterial strains are vital to combat antimicrobial resistance. This study shows that MDR and XDR infections are a major health problem in ICUs and that these infections have significant negative effects on patient prognosis.

Aim: This study aims to evaluate the effects of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, C-reactive protein/albumin ratio (CAR), and platelet/lymphocyte ratio (PLR) on predicting mortality in geriatric patients admitted to the respiratory intensive care unit (ICU). Materials and Methods: In this retrospective observational cohort study, data of patients followed up in the respiratory ICU between 01.07.2021 and 31.12.2023 were evaluated. Age, gender, HALP score, hemoglobin, albumin, lymphocyte, platelet, and C-reactive protein (CRP) levels, along with PLR, CAR, and patient prognosis (exitus/discharge), were recorded from patient files and the hospital data processing system. Results: The study included 405 patients (140 women and 265 men) over 65 years of age. In multivariate analysis, higher PLR and CAR values were associated with a higher mortality rate, whereas patients with a higher HALP score had a lower mortality rate (p< 0.001). In the ROC analysis, a statistically significant cut-off value was found for the HALP score in predicting mortality (p< 0.001). HALP score ≤ 9.94 indicates mortality, with a sensitivity of 67.25%, specificity of 53%, PPV (positive predictive value) of 64.98%, and NPV (negative predictive value) of 55%. CAR value ≥ 30.13 indicates mortality, with a sensitivity of 69.87%, specificity of 61.36%, PPV of 70.18% and NPV of 61.02%. There was no statistically significant cut-off value for PLR in predicting mortality (p=0.076). Conclusion: We found that the HALP score, PLR value, and CAR value are important scores that may be useful in determining mortality and treatment modality in geriatric patients treated in the ICU.

Objective: We aimed to evaluate the usability of the Shock Index (SI), Modified Shock Index (MSI), and Age Shock Index (ASI) in predicting clinical outcomes and mortality in sepsis patients followed in the intensive care unit. Methods: Records of patients admitted to the intensive care unit of Muş State Hospital between January 2022, and April 2024, who developed sepsis were retrospectively recorded from the hospital data system. Results: A total of 127 patients were included in the study. The average age of these patients was found to be 50.83±12.01 years. The average age of discharged patients was 46.14±10.12 years, while the average age of deceased patients was 58.54±10.89 years. In the gender distribution, 63.78% of all patients were male and 36.22% were female (p=0.028). SI was determined as 0.88±0.33 in discharged patients and 1.11±0.32 in deceased patients (p=0.0002). MSI was found to be 1.45±0.33 in discharged patients and 1.68±0.32 in deceased patients (p=0.00001). ASI was determined as 40.73±18.41 in discharged patients and 64.94±22.85 in deceased patients (p=0.0001). The cut-off value for SI was found to be 0.76, with an AUC value of 0.69. The cut-off value for the MSI was determined to be 1.35, with an AUC value of 0.72. The cut-off value for the ASI was found to be 38.76, with an AUC value of 0.85. Conclusion: All three shock indices were statistically significant in predicting mortality in sepsis patients. We believe they are valuable indices that can be used bedside and non-invasively in intensive care units.

Background: This study aims to evaluate the prognostic value of Systemic Immune-Inflammation Index (SII), Platelet-Lymphocyte Ratio (PLR) and Neutrophil-Lymphocyte Ratio (NLR) to predict mortality in patients with pneumosepsis in the intensive care unit (ICU). Materials and Methods: The study was conducted retrospectively and clinical data of patients diag-nosed with pneumosepsis were analyzed. Age, gender, comorbidities, length of stay (LOS) in the ICU, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, SII, PLR, NLR values and prognoses were obtained from patient files and hospital records system. Results: A total of 68 patients were included in the study. 60.3% of the patients were male and 39.7% were female. The mean age of deceased patients was statistically significantly higher than that of discharged patients (p = 0.016). In the study, 22 patients were discharged and 46 patients died. While the mean SII value was 464.05±107.31 in the discharged group, this value was 845.53±111.04 in those who died (p<0.001). Similarly, the PLR value was 88.14 ± 10.66 in those discharged and 114.89±12.97 in those who died (p<0.001). The NLR value was 3.5 ± 0.86 in the discharged group and 6.73±0.84 in the deceased group (p<0.001). Conclusions: This study reveals that SII, NLR and PLR indices are important and reliable indicators for predicting mortality in pneumosepsis patients in the ICU.