Background/Objectives: The Charlson Comorbidity Index (CCI) is designed for evaluating comorbidities and mortality risks, with the age-adjusted CCI (ACCI) combining age and comorbidity assessments. Despite its long-standing use, research on CCI’s application in cardiac surgery patients is limited. This study assessed the effectiveness of CCI and ACCI in predicting in-hospital mortality and post-surgery outcomes for patients undergoing isolated coronary artery bypass grafting (CABG). Methods: CCI and ACCI scores were derived from medical records between 2016 and 2022. Patient demographics, surgical techniques, and postoperative complications were documented. Results: Totally 393 patients [297 (75.6%) males, 96 (24.4%) females] with an average age of 65 years were included. Median CCI and ACCI scores were 1 (1–2) and 4 (3–5), respectively. In-hospital mortality occurred in 5.9% (n = 23) of cases, with CCI being an independent predictor (OR 1.865, 95% CI 1.117–3.116; p = 0.017). Both CCI and ACCI scores negatively correlated with preoperative EF (%) and positively correlated with ICU and total hospital stay, cardiopulmonary bypass time, and cross-clamp time. ACCI score also positively correlated with extubation time. Patients categorized by CCI comorbidity severity (no comorbidity, mild, moderate, severe) showed a significant increase in postoperative complications with increasing severity, including postoperative VT (p = 0.000), acute renal failure (p = 0.009), pneumonia (p = 0.007), and in-hospital mortality (p = 0.001). Conclusions: Both CCI and ACCI are prognostic indicators for in-hospital mortality in isolated CABG surgery patients, effectively predicting postoperative complications, extended ICU stays, and prolonged hospital stays. Implementing these scoring systems could enhance patient care and improve surgical decision-making.

Background/Objectives: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic interstitial lung disease with high mortality and limited treatment options. Despite recent therapeutic advances, predicting survival remains challenging. Given the challenge of predicting disease progression in IPF, identifying reliable prognostic markers may support individualized treatment strategies, guide follow-up intensity, and improve clinical decision making. This study aimed to evaluate mortality rates and factors associated with poor prognosis in patients with IPF over a 10-year period at a tertiary care center. Methods: Medical records of 268 patients diagnosed with IPF between 2015 and 2024 were retrospectively reviewed. Demographic characteristics, comorbidities, radiological findings, pulmonary function test results, frequency of exacerbations and hospitalizations, treatment details, and survival outcomes were analyzed. Univariate and multivariate logistic regression analyses were performed to identify predictors of mortality. Results: This study included 268 patients (77.2% male; median age, 72 years). During a median follow-up of 24 months, 44% (n = 118) of patients died. Deceased patients were older (p < 0.001) and had higher rates of coronary artery disease, pulmonary embolism, pulmonary hypertension, and malignancy (all p < 0.05). A definite UIP pattern was more common among deceased patients (71.2% vs. 52.4%, p = 0.02). Acute exacerbations (23.3% vs. 8.1%) and hospitalizations (61.9% vs. 23.3%) were significantly more frequent in this group (p < 0.001). In multivariate analysis, GAP score (OR 11.68, p = 0.001), pulmonary hypertension (OR 15.39, p = 0.02), history of exacerbation (OR 56.2, p = 0.04), baseline FVC (OR 1.10, p = 0.02), mean platelet volume (OR 0.29, p = 0.01), and AST level (OR 1.12, p = 0.04) were independent predictors of mortality. Conclusions: Despite advances in management, IPF continues to carry a high mortality risk. This study represents one of the largest single-center IPF cohorts from our region with long-term real-life follow-up and additionally evaluates laboratory biomarkers such as MPV and AST, which have not been widely investigated as prognostic indicators in IPF. Advanced age, reduced pulmonary function, comorbidities, and acute exacerbations are major prognostic factors. Early recognition and proactive management of these parameters may help improve survival outcomes.

AMAÇ Bu çalışmanın amacı, üst solunum yolu örneklerinde COVID-19 RT-PCR tetkiki negatif bulunan fakat tipik radyolojik bulguları nedeniyle COVID-19 pnömonisi olarak kabul edilen hastalarda COVID-19 antikor tetkiki sonuçlarının değerlendirilmesidir. GEREÇ VE YÖNTEMLER Hastanemizde yatırılan COVID-19 pnömonisi açısından tipik bulguları olan 28 hastadan periferik kanda ELISA yöntemi ile SARS-CoV2 Total (IgM + IgG) ve IgG antikor düzeylerinin çalışıldı. 10 hastanın yatış sırasında PCR tetkiki pozitif (kesin COVID-19 pnömonisi), 18 hastanın ise PCR tetkiki negatif (olası COVID-19 pnömonisi) olduğu görüldü. Kontrol grubu olarak Kasım 2019-Mart 2020 tarihleri arasında, ülkemizde ilk COVID-19 hastası tespit edilmeden önce yatırılan ve radyolojik bulguları COVID-19 pnömonisi ile uyumlu olarak değerlendirilen 10 hasta alındı (kontrol). BULGULAR Kontrol grubu olarak alınan hastaların hiç birinde COVID-19 antikoru tespit edilmezken, radyolojik olarak COVID-19 pnömonisi tanısı alan 28 hastanın 22 tanesinde (%78.6) antikor pozitif bulundu. Kesin COVID-19 pnömonisi olan hastaların sadece 1 tanesinde antikor negatif bulundu. Bu hastanın yaygın Non-Hodgkin Lenfoma tanısı ile halen kemoterapi almakta olduğu tespit edildi. Olası COVID-19 pnömonisi grubunda 5 hastada antikor tespit edilmedi (%27.7). Bu hastaların ikisinin multipl miyelom tanılı olduğu, üç hastanın ise 75 yaş üzeri olduğu dikkati çekti. Kesin ve olası COVID-19 grupları arasında ortalama total ve IgG antikor düzeyleri açısından anlamlı fark tespit edilmedi (IgG düzeyleri 2.57 ± 1.08 vs 2.84 ± 0.9, p=0.6). SONUÇ Pandemi döneminde radyolojik olarak COVID-19 pnömonisi düşünülen hastalarda geçirilmiş COVID enfeksiyonu tanısı için COVID-19 antikor düzeyleri kullanılabilir. Fakat, yaşlı ve hematolojik malignite başta olmak üzere immunsupresyonu olan hastalarda yeterli antikor yanıtı oluşmayabileceği, bu nedenle geçirilmiş enfeksiyonu göstermenin güç olabileceği akılda tutulmalıdır.

Click on the article title to read more.

Background: Sarcoidosis is a disease characterized by heterogeneity in terms of duration and severity. Currently, there isn't biomarker with high specificity and sensitivity for sarcoidosis. However, recent studies have shown that Vanin-1 may be associated with oxidative stress, inflammation and fibrosis. Objective: The aim of this study is to compare the serum levels of Vanin-1 between patients with sarcoidosis and healthy individuals. The study will examine the role of serum Vanin-1 levels in diagnosing the disease and determining its clinical stage. Method: The study included 42 sarcoidosis patients and 42 healthy subjects. Vanin-1 level was analysed in addition to standard tests for diagnosis and follow-up of patients with sarcoidosis. The sensitivity and specificity of serum Vanin-1 levels for the diagnosis of sarcoidosis were evaluate dusing ROC analysis. Results: Serum Vanin-1 levels were statistically significantly lower in the patient group compared to the control group [547.3 ng/L-1032.2 ng/L p<0.001]. When patients were classified into stages based on chest X-ray, no statistically significant differences were observed between stages in terms of serum Vanin-1 levels. The cut-off value for serum Vanin-1 level for the diagnosis of sarcoidosis was calculated as 724.1 (AUC: 0.714, 95%) with a sensitivity of 75.5% and specificity of 62.7%. Conclusion: This study is the first to investigate Vanin-1 levels in patients with sarcoidosis. Although our study did not show a significant difference between the radiological stages of sarcoidosis and serum Vanin-1 levels, due to the limited sample size, it is considered necessary to conduct further studies with a larger number of patients.

Background/Objectives: Idiopathic pulmonary fibrosis (IPF) frequently coexists with comorbidities that may influence clinical outcomes. The Charlson Comorbidity Index (CCI) quantifies the weighted comorbidity burden, whereas the age-adjusted Charlson Comorbidity Index (ACCI) additionally incorporates age. We evaluated the associations of CCI and ACCI with pulmonary function, disease severity, clinical course, and mortality in IPF. Methods: This retrospective, single-center cohort study included 319 patients with IPF. Comorbidities present at diagnosis were scored using the CCI and ACCI. Associations with pulmonary function, GAP index, acute exacerbations, hospitalization, long-term oxygen therapy, echocardiographic findings suggestive of pulmonary hypertension, incident malignancy, antifibrotic treatment, and mortality were assessed. Correlation analyses were performed using Spearman’s rank correlation coefficient, and Bonferroni correction was applied to account for multiple testing. Multivariable Cox proportional hazards regression was used to evaluate whether the CCI or ACCI was independently associated with survival. Time-to-event analyses were performed using Kaplan–Meier survival analysis. Results: The mean age was 71 ± 8 years, 78.1% were male, and 75.5% had at least one comorbid condition among patients with available comorbidity data. The median CCI and ACCI scores were 2 (IQR, 0–4) and 5 (IQR, 4–7), respectively. Higher CCI and ACCI categories were associated with hospitalization (p = 0.006 and p = 0.011), echocardiographic findings suggestive of pulmonary hypertension (both p = 0.002), and incident malignancy (p < 0.001 and p = 0.005, respectively). After Bonferroni correction, higher CCI and ACCI categories remained significantly associated with echocardiographic findings suggestive of pulmonary hypertension (both p = 0.002) and incident malignancy (both p < 0.001), whereas the associations with hospitalization did not remain statistically significant. A nominal association between ACCI and mortality (p = 0.044) also did not remain significant after Bonferroni correction. In Spearman analyses, ACCI remained significantly correlated with current age, age at IPF diagnosis, and the GAP index after correction, whereas the correlations of CCI and ACCI with baseline DLCO did not. Neither CCI (HR = 1.029, 95% CI: 0.923–1.146; p = 0.610) nor ACCI (HR = 1.035, 95% CI: 0.936–1.144; p = 0.509) was independently associated with survival in multivariable Cox regression analyses. Lower baseline DLCO remained independently associated with survival in both Cox models (both p < 0.001).Kaplan–Meier survival curves were constructed according to the predefined CCI and ACCI score categories (0, 1–2, 3–4, and ≥5), and survival distributions across categories were compared using the log-rank test. Conclusions: CCI and ACCI were associated with selected clinical characteristics in IPF, particularly echocardiographic findings suggestive of pulmonary hypertension and incident malignancy. However, neither index independently predicted survival after multivariable adjustment. These indices may complement, rather than replace, disease-specific physiological assessments in patients with IPF.