Background/Objectives: In recent years, inflammatory markers have been increasingly utilized to predict disease prognosis. The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a novel biomarker reflecting inflammation and systemic response. This study was conducted to evaluate the prognostic value of NPAR in pneumonia patients aged 80 years and older hospitalized in intensive care. Methods: Patients aged 80 years and older who were followed up in the intensive care unit with a diagnosis of pneumonia between 1 October 2022, and 31 May 2024, were retrospectively reviewed. Demographic characteristics, laboratory data, disease severity scores (APACHE II, SOFA), intensive care interventions, and variables associated with mortality were analyzed. NPAR was calculated by dividing the neutrophil percentage by the serum albumin level. The prognostic value of NPAR was assessed using Kaplan–Meier survival analysis, receiver operating characteristic (ROC) curve analysis, and Cox regression analysis. Results: A total of 135 patients were included in the study. Patients with NPAR > 0.286 had significantly higher SOFA (p = 0.002) and APACHE II (p = 0.007) scores. The high NPAR group was at significantly greater risk for requiring invasive mechanical ventilation (p = 0.003), vasopressor support (p = 0.042), and developing sepsis (p = 0.035). Elevated NPAR was strongly associated with mortality (p < 0.001) and was identified as an independent predictor of mortality in the Cox regression analysis (HR = 2.488, 95% CI: 1.167–5.302, p = 0.018). Conclusions: NPAR may serve as an effective biomarker for predicting disease severity and mortality risk in pneumonia patients aged 80 years and older. Due to its simplicity and accessibility, it can be considered a practical parameter for integration into clinical practice. However, large-scale, multicenter, and prospective studies are needed to validate these findings.

Background/Objectives: Hypercapnic respiratory failure (HRF) is a primary cause of admittance to the intensive care unit (ICU). This study aimed to investigate the factors that affect the length of hospital stay in HRF patients. Methods: This study was designed as a retrospective, cross-sectional analysis of patients who were admitted to the ICU because of HRF between 2022 and 2024. The demographic and clinical characteristics of the patients and laboratory results were recorded. The Charlson Comorbidity Index (CCI) was calculated. The relationship between these parameters and the length of hospital stay was assessed. Results: A total of 138 patients were included in the study. The average length of hospital stay was 11.45 days, and 37% of the patients were included in the long-term hospitalization group. The degree of hypercapnia was not associated with the length of hospital stay. It was determined that the patients’ albumin levels and CCI were significant determinants of the length of hospital stay. The combined assessment of these two parameters was found to be superior compared to their separate evaluations. Conclusions: In our study, hypoalbuminemia and a higher CCI were identified as predictors of a prolonged ICU stay in HRF patients. Albumin levels of <3.25 g/dL and CCI scores of ≥5 were linked to longer stays, with this combined evaluation offering greater predictive value. These factors can guide patient management.

Background: Atrial fibrillation (AF) frequently occurs in individuals with hypercapnic type 2 respiratory failure and has the potential to adversely affect patient outcomes. This study sought to investigate the clinical features and prognostic significance of atrial fibrillation in patients admitted to the intensive care unit with hypercapnic type 2 respiratory failure. Methods: This retrospective, single-center study included 200 adult patients diagnosed with hypercapnic type 2 respiratory failure between May 2022 and May 2023. Patients were grouped according to whether atrial fibrillation was present or not. Demographic, laboratory, and echocardiographic findings, comorbidities, and outcomes were compared. Kaplan–Meier survival analysis and Cox regression were used to identify mortality predictors. Results: AF was present in 50.5% of patients. Those with AF were older, had higher Charlson Comorbidity Index scores, and a greater prevalence of heart failure (p < 0.001). No significant differences were found in arterial blood gas values. AF patients had higher urea, creatinine, and BNP levels, and lower hemoglobin, lymphocyte, eosinophil, and monocyte counts (p < 0.05). Echocardiography showed more severe tricuspid and mitral regurgitation, lower ejection fractions, and higher systolic pulmonary pressures in the AF group. About 20% of AF patients were not receiving anticoagulants at ICU admission. AF was associated with shorter survival (49.6 ± 4.07 vs. 61.4 ± 3.8 days, p = 0.031) and 1.6-fold higher mortality risk (HR: 1.60, 95% CI: 1.04–2.47). Advanced age and low hemoglobin were independent predictors of mortality. Conclusions: AF is frequent among patients with type 2 respiratory failure and is linked to increased mortality. Despite known complications, treatment remains underutilized. AF should be actively screened during ICU admissions for respiratory failure.

Background and Objectives: Hypercapnic respiratory failure (HRF) is a critical clinical condition commonly encountered in acute exacerbations of chronic obstructive pulmonary disease (COPD), leading to high morbidity and mortality rates. The existing scoring systems have primarily been developed for short-term mortality prediction, and their impact on long-term survival has not been sufficiently investigated. This study aims to identify the prognostic factors affecting long-term survival in patients with persistent HRF due to COPD and to evaluate the effectiveness of the Age-Adjusted DECAF (A-DECAF) score, which was created by incorporating the age variable into the existing DECAF score, in predicting long-term survival. Materials and Methods: This retrospective study included patients admitted to an intensive care unit from an emergency department with HRF between April 2022 and November 2023. The demographic data, comorbidities, the laboratory results, and the treatment protocols were recorded. The A-DECAF scores were calculated and analyzed using Kaplan–Meier and ROC analyses. Survival assessment was conducted with Kaplan–Meier analysis, while univariate and multivariate Cox regression analyses were performed to identify the prognostic factors. Results: Among 357 patients, 24.4% died within one year after discharge. The deceased patients were significantly older (p < 0.001) and had higher APACHE-II, DECAF, and A-DECAF scores (p < 0.001 for all). ROC analysis showed that the A-DECAF score had the highest sensitivity (93.1%) and accuracy (AUC = 0.813) for survival prediction. Kaplan–Meier analysis indicated lower survival rates with increasing A-DECAF scores. Cox regression identified the A-DECAF score as the strongest independent predictor (p < 0.001), while lung cancer (p = 0.044) and invasive mechanical ventilation (p = 0.039) also negatively impacted survival. Conclusions: The A-DECAF score is an effective tool for predicting long-term survival in patients with COPD and persistent HRF, particularly aiding clinical decisions regarding elderly populations. Further research is needed to validate its use in diverse patient groups.

Introduction/Objective: In recent years, inflammatory markers have been increasingly utilized to predict disease prognosis. The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a novel biomarker reflecting inflammation and systemic response. This study was conducted to evaluate the prognostic value of NPAR in pneumonia patients aged 80 years and older hospitalized in intensive care. Methods: Patients aged 80 years and older who were followed up in the intensive care unit with a diagnosis of pneumonia between October 1, 2022, and May 31, 2024, were retrospectively reviewed. Demographic characteristics, laboratory data, disease severity scores (APACHE II, SOFA), intensive care interventions, and variables associated with mortality were analyzed. NPAR was calculated by dividing the neutrophil percentage by the serum albumin level. The prognostic value of NPAR was assessed using Kaplan–Meier survival analysis, receiver operating characteristic (ROC) curve analysis, and Cox regression analysis. Results: A total of 135 patients were included in the study. Patients with NPAR > 0.286 had significantly higher SOFA (p = 0.002) and APACHE II (p = 0.007) scores. The high NPAR group was at significantly greater risk for requiring invasive mechanical ventilation (p = 0.003), vasopressor support (p = 0.042), and developing sepsis (p = 0.035). Elevated NPAR was strongly associated with mortality (p < 0.001) and was identified as an independent predictor of mortality in Cox regression analysis (HR = 2.488, 95% CI: 1.167–5.302, p = 0.018). Conclusion: NPAR may serve as an effective biomarker for predicting disease severity and mortality risk in pneumonia patients aged 80 years and older. Due to its simplicity and accessibility, it can be considered a practical parameter for integration into clinical practice. However, large-scale, multicenter, and prospective studies are needed to validate these findings.

Background and Objectives: To contribute to clinical practice by identifying gender-based differences in patients diagnosed with chronic obstructive pulmonary disease (COPD) who are monitored in the intensive care unit due to type 2 respiratory failure. Materials and Methods: The study was planned as a prospective, observational, and cross-sectional investigation. A total of 258 patients, 91 females and 167 males, were included in the study between 2023 and 2024. Demographic data and clinical parameters of COPD patients admitted to intensive care due to hypercapnic respiratory failure and treated with noninvasive ventilation (NIV) were compared between genders. Results: The number of male patients was higher than female patients, while the mean age of female patients was higher than that of males. The body mass index (BMI), morbid obesity, atrial fibrillation, renal disease, heart failure, hypertension, hypothyroidism, the Charlson Comorbidity Index (CCI), and the cardiothoracic ratio were found to be significantly higher in female patients. Emphysema and steroid use in treatment were more common in male patients. In laboratory analyses conducted at the time of admission, the average D-dimer and brain natriuretic peptide (BNP) levels were higher in female patients. The mean arterial carbon dioxide pressure (PaCO₂) level assessed prior to discharge was also higher in female patients. Conclusions: Heart failure and risk factors that may lead to heart failure are more prominent in female COPD patients with type 2 respiratory failure. Despite the lower number of female patients compared to males, the significantly higher comorbidity burden in females, as per CCI scores, suggests that medical processes may be more challenging to manage in females. We believe that these findings will contribute to clinical practice and provide clinicians with insights for patient management.