In this study, we aimed to examine the effect of neutrophil-lymphocyte ratio (NLR) on mortality and morbidity in elderly patients over the age of 65 who presented to our clinic and were operated on due to hip fracture. The study included patients over the age of 65 who were operated on in our hospital between January 2014 and December 2018 due to hip fracture. Those with multiple fractures and those who were operated on due to cancer-related fracture were excluded. Patients' age, gender, American Society of Anesthesiologists (ASA) score, preoperative waiting time, type of anesthesia, operation duration, amount of erythrocyte suspension used, and duration of intensive care unit (ICU) stay were recorded. The effect of increased preoperative and postoperative 5th day neutrophil-lymphocyte ratios (NLR 1 and NLR 5, respectively) on mortality and morbidity was investigated. We examined 132 patients operated on due to hip fracture. NLR 5 was higher among patients who were admitted to the ICU (p = 0.007) and among those who died (p = 0.007). Additionally, the rate of increase of NLR 5 was higher among patients who were admitted to the ICU (p = 0.044) and among those died (p = 0.009). The rate of increase of NLR in the postoperative period can be used as a criterion for predicting mortality in patients who are operated on due to hip fracture.

Background: Post-cardiac arrest syndrome is the insufficiency of cardiac and cerebral functions caused by ischemia after sudden cardiac arrest. We aimed to determine the hematological parameters associated with mortality in the intensive care follow-up of patients with post-cardiac arrest syndrome. Methods: The hematological parameters of 285 cardiovascular patients who were admitted to the emergency department of Harran University Medical Faculty between 2013 and 2018 and followed up in the intensive care unit with post-cardiac arrest syndrome were examined. A total of 85 patients were included in the study. These parameters were recorded as the time of arrival to the emergency department (0 hour) and hematological parameters at the 24^th and 48^th hours of intensive care follow-up. Results: In the mortality group, albumin (P:0.030), hemoglobin (Hg) (P: 0.049), and hematocrit (HCT) (P: 0.020) values ​​in the blood parameters, at the time of admission to the emergency department, were significantly lower than those in the survival group. Red blood cell distribution width (RDW) (P: 0.009) and urea (P <0.001) values ​​at the time of arrival were higher than the survival group. In the 24^th and 48^th hours, mean hemoglobin (MCHC) (P <0.05) values ​​were lower and RDW (P <0.05) values ​​were higher in the mortality group compared to the survival group. Conclusions: In this retrospective validation, low albumin, Hg, HCT, MCHC, and high RDW and urea levels may increase mortality in cardiovascular patients who develop post-cardiac arrest syndrome within the first 48 hours. Correcting these values ​​early may reduce mortality.

Background and Objectives: Prognostic stratification in trauma patients admitted to the intensive care unit (ICU) remains a clinical challenge. While conventional scoring systems such as Acute Physiology and Chronic Health Evaluation II (APACHE II), Injury Severity Score (ISS), and Glasgow Coma Scale (GCS) are widely used, the utility of biochemical biomarkers in predicting mortality is still evolving. This study aimed to evaluate the prognostic value of key inflammatory and metabolic biomarkers: platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), serum lactate, base deficit, and neutrophil-to-lymphocyte ratio (NLR) in relation to ICU mortality in trauma patients. Materials and Methods: In this retrospective cohort study, data from 240 ICU-admitted trauma patients were analyzed. Group comparisons between survivors and non-survivors were conducted using t-tests or Mann–Whitney-U tests. Pearson correlation and ROC analyses were performed to assess relationships and discriminatory performance of biomarkers alongside clinical scores. Results: Non-survivors (n = 50) exhibited significantly higher CAR, lactate, and base-deficit values, and lower PLR (p < 0.05) compared to survivors (n = 190). CAR strongly correlated with CRP (r = 0.96), while lactate and base deficit were inversely correlated (r = –0.69). ROC analysis revealed that ISS (AUC = 0.86) and APACHE II (AUC = 0.77) had the highest discriminatory power, followed by lactate (AUC = 0.75). NLR did not demonstrate significant prognostic utility (p > 0.05). Conclusion: PLR, CAR, lactate, and base deficit are accessible, cost-effective biomarkers with significant prognostic value in ICU trauma care. Their integration with established scoring systems can enhance early risk stratification. NLR, however, may require time-sensitive and context-specific evaluation.

Introduction: Evaluation of the prognosis in the early period of intensive care patients and arranging the treatment accordingly is of vital importance. In the present study, we investigated whether serum thiol/disulphide concentration can be used in the follow-up of prognosis in the early period in patients with COVID-19 under intensive care. Methods: The study included 25 patients [their ages were between 19 and 92; 10 (40%) were male and 15 (60%) were female] who were diagnosed with COVID-19 and treated in the intensive care unit (ICU). The patients were followed for four weeks. On the first, third, and fifth days of intensive care treatment, venous blood samples were taken from the patients to analyze the thiol/disulphide parameters, and coma scores were calculated. Statistical analyses were conducted to evaluate the relationship between thiol/disulphide levels and the prognosis of COVID-19 patients. Results: At the end of the four-week follow-up of the patients included in the study, 9 were discharged and 16 died. In patients who died, the relationship between thiol/disulphide homeostasis parameters and coma scores was not statistically significant. Meanwhile, in discharged patients, the relationship between disulphide concentration, total thiol, and coma scores was statistically significant. Conclusion: The relationship between thiol/disulphide homeostasis and coma scores in COVID-19 patients treated in the intensive care unit may help to evaluate the prognosis of the disease in the early period, thus the effectiveness of medical intervention.

Background and Objectives: The erector spinae plane block (ESPB) is an emerging regional anesthesia technique that has demonstrated effectiveness in reducing postoperative pain and opioid consumption following laparoscopic cholecystectomy (LC). However, the optimal timing of ESPB whether administered preoperatively or postoperatively remains uncertain, particularly regarding its influence on intraoperative hemodynamic stability and procedural feasibility. This study aimed to compare the analgesic efficacy, intraoperative hemodynamic profiles, and procedural advantages of preoperative versus postoperative ESPB in patients undergoing elective LC. Materials and Methods: In this prospective, randomized, and single-blind clinical trial, 80 ASA I–II adult patients scheduled for elective LC were randomly assigned to receive bilateral ESPB either before anesthesia induction (Group 1) or immediately after surgery but prior to extubation (Group 2). All patients received standardized general anesthesia. The primary outcome was postoperative pain measured by the numeric rating scale (NRS) at 2 h postoperatively. Secondary outcomes included NRS scores at other time points (0, 4, 6, 12, and 24 h), intraoperative and postoperative hemodynamic parameters, cumulative 24 h rescue analgesic consumption, patient satisfaction scores, and adverse events. Results: Both groups experienced significant reductions in postoperative NRS scores, with no statistically significant differences between groups in pain intensity or tramadol consumption. However, the preoperative ESPB group exhibited significantly more stable intraoperative blood pressure readings, particularly at 30 and 60 min after incision and at extubation. No ESPB-related complications occurred in either group. Patient satisfaction levels were comparable across groups. Conclusions: Preoperative and postoperative ESPBs offer comparable analgesic efficacy and opioid sparing effects in LC. However, preoperative ESPB provides enhanced intraoperative hemodynamic stability and avoids the logistical challenges of performing blocks under anesthesia, including repositioning related risks. These findings suggest that preoperative ESPB may be considered for integration into enhanced recovery after surgery (ERAS) protocols for minimally invasive biliary surgery, pending further large-scale multicenter trials.

Background: In blood samples taken for testing purposes during drug infusion in the intensive care unit, there is a risk of interference due to drug-reactive interaction during the analysis. Case Report: A 19-year-old female patient had undergone surgery for intracranial astrocytoma, 12 years ago. Acinetobacter baumannii was found in the blood culture and deep tracheal aspiration fluid of the patient who had a fever (39.2 °C) with a body temperature during the follow-up. The patient was started on colistin 2 * 4.5 million IU. After the colistin infusion, biochemical tests were requested to control the patient’s clinical situation. CK-MB mass and ProBNP values were measured in high concentrations. Cardiology consultation was requested to evaluate the increase in the CK-MB mass and ProBNP values. The patient's ECG and echocardiography showed no abnormality. The increase in cardiac markers was neither clinically acceptable nor insignificant. There was no hemolysis in the sample or analytical error in the device. Variability in the tests was thought to be due to the interference. As the bloodletting time was questioned, it was determined that it was taken during colistin treatment. In order to determine the effect of colistin-related interference on the other tests, the laboratory was contacted and additional tests (TSH, FT4, Anti- TPO, B-HCG, Estradiol, Prolactin, CA 125, CA 15-3, CA 19-9, Vitamin B12, C-Peptide, DDimer, PTH, 25 hydroxy vitamin D, PT, INR, APTT) were conducted. During colistin treatment, in many tests, bias was detected between -75 and + 268.80%. Conclusion: Clinicians should consider suspicious test results that are incompatible with the diagnosis for the possibility of erroneous measurements due to colistin interference and review the sampling processes.