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 and Objectives: Acute exacerbation of idiopathic pulmonary fibrosis (IPF-AE) often results in severe respiratory distress requiring treatment in the intensive care unit and has a high mortality rate. Identifying prognostic markers and assessing disease severity are crucial for clinicians to gain detailed insights. The mean platelet volume-to-platelet count ratio (MPR) is an inflammatory marker commonly used in malignancies. This study aimed to evaluate MPR and other factors affecting mortality in patients with IPF-AE who were monitored in the intensive care unit (ICU). Materials and Methods: This retrospective study was conducted on patients monitored in the ICU for IPF-AE between 2017 and 2023. Demographic characteristics, vital signs, laboratory and imaging findings, and administered treatments were reviewed. MPR was calculated by dividing the mean platelet volume by the platelet count. The primary endpoint was defined as 1-month in-hospital mortality. Results: A total of 59 patients monitored in the ICU for IPF-AE were included in the study. The mean age of the patients was 62.75 years, and 81.4% of the participants were male. During the 30-day follow-up period, 62.7% of the patients died. The need for invasive mechanical ventilation (IMV) was significantly associated with increased mortality (p < 0.001). The optimal cutoff value for MPR was determined to be 0.033, with a sensitivity of 83.7% and specificity of 63.64%, indicating its predictive value for mortality (AUC: 0.764; 95% CI: 0.635–0.864; p < 0.001). Conclusions: In this study, the need for IMV emerged as a critical parameter in predicting mortality in patients with IPF-AE. Additionally, the use of the MPR as a prognostic biomarker may offer a novel approach in the management of IPF patients. These findings could contribute to the development of strategies aimed at early intervention in IPF patients. Further studies with larger sample sizes are needed to validate these results. This study has demonstrated that MPR is a significant prognostic biomarker for predicting mortality in patients with IPF-AE who are managed in the intensive care unit. The potential use of MPR as a biomarker in clinical decision-making may provide new approaches to the management of IPF patients. Additionally, the need for IMV in IPF-AE emerges as a critical parameter for predicting mortality. These findings may contribute to the development of early intervention strategies for IPF patients. Further studies with larger cohorts are needed to validate these results.

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.

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.

Aims: Fiberoptic bronchoscopy (FOB), although generally considered safe, can lead to significant complications, particularly in critically ill patients. This study aimed to evaluate the indications, complications, and bronchoscopic culture results of FOB in patients monitored in the intensive care unit (ICU). Methods: FOBs performed in the respiratory ICU between December 2021 and July 2024 were evaluated. The indications for FOB, complication rates, and bronchoscopic culture results were analyzed. The relationship between culture growth and inflammatory markers was also assessed. Results: In this study, a total of 454 FOB procedures were performed on 234 patients hospitalized in the ICU. The most common indication for FOB was secretion clearance, accounting for 41.9% of cases. The most frequent procedure-related complications were transient hypoxemia (9%) and minor bleeding (7%). The growth rate in bronchoscopic cultures was determined as 53.2%, while Acinetobacter spp. (11.2%), Pseudomonas spp. (7.3%), and Klebsiella pneumoniae (12.6%) were detected as resistant bacteria. Additionally, a weak but statistically significant correlation was found between CRP levels and bronchoscopic culture growth (p=0.040). Conclusion: FOB is a safely applicable and valuable diagnostic tool in infection management in the ICU. Bronchoscopic cultures can guide targeted antibiotic therapy. However, these findings need to be supported by large-scale studies.

Although emphysema is typically associated with older age and the presence of airflow limitation, it can also be detected in young adults prior to the development of obstructive impairment. In this study, we aimed to investigate the relationship between the radiological characteristics of emphysema, pulmonary function test results, and symptom severity in patients aged 20 to 50 years who presented with complaints of dyspnea. In this retrospective study, patients with emphysema detected on computed tomography (CT) but without airflow limitation on spirometry were evaluated. Demographic characteristics, type and extent of emphysema, pulmonary function tests, and Modified Medical Research Council (mMRC) dyspnea scores were assessed. Patients were classified into preserved ratio impaired spirometry (PRISm) and pre-COPD groups, and these groups were compared in terms of clinical and symptomatic features. The mean age of the patients was 44 years, and 84.6% were male. The most common type of emphysema was paraseptal (43.6%), and the extent of emphysema was less than 5% in the majority of cases (78.4%). A negative correlation was found between the degree of emphysema and both FEV₁ (Forced Expiratory Volume in 1 Second) and FVC (Forced Vital Capacity), while a positive correlation was observed with the mMRC (Modified Medical Research Council) dyspnea score. Dyspnea was more pronounced in the PRISm group (p< 0.001). Emphysema detected in young adults without airflow limitation may have significant effects on symptom burden and pulmonary capacity. The PRISm phenotype, in particular, is notable for its association with increased symptom severity and a history of smoking, highlighting the importance of early identification of these individuals. Our findings underscore the value of early detection; however, further studies are needed to better understand the follow-up and management of this patient population.