Background: Prognostic scoring systems are applied in intensive care units (ICUs) to monitor patients’ responses to treatment and guide treatment modalities. These scoring systems are also used as predictors in sepsis, where mortality rates are high. This study aims to compare the scores (APACHE II, SOFA, SAPS II, OASIS) in terms of their role in predicting overall mortality in patients admitted to ICUs with a diagnosis of sepsis or septic shock. Methods: Among 740 patients admitted to the tertiary intensive care unit within a 2-year period, 165 patients diagnosed with sepsis and septic shock were included in the study. Demographic data, comorbidities, SOFA, SAPSII, OASIS, and APACHE II scores, invasive or noninvasive mechanical ventilation requirements and durations, ICU admissions, hospital stays, and 28-day mortalities were retrospectively evaluated. Results: All scoring systems were positively correlated with mortality and CCI score. SAPS II and OASIS showed a higher correlation with mortality compared to other scoring systems, correlated with ICU admission and mechanical ventilation, unlike other scoring systems. The AUC values for the APACHE II, SOFA, SAPS II, and OASIS were 0.803, 0.873, 0.902, and 0.879, respectively. No statistically significant difference was found between the scores (p > 0.05). Conclusions: Compared to commonly used scoring systems, OASIS is a practical tool and serves as a robust scoring system for assessing mortality in ICU patients diagnosed with sepsis.

Background and Objectives: Frailty can represent the transitional stage between successful aging and old age in need of care; it is a guide for setting goals for regaining robust old age in the individual at risk. Frailty is associated with longer intensive care unit duration, hospital stay, and higher mortality. The aim of this study was to evaluate the relationship between mortality and frailty in geriatric patients (65 years and older) admitted to the intensive care unit with a diagnosis of pneumonia. Materials and Methods: In total, 478 patients were included in the study. The demographic data, such as age, gender, body mass index (BMI), Charlson comorbidity index (CCI), Clinical Frailty Scale (CFS), acute physiology and chronic health evaluation (APACHE II) scores, sequential organ failure assessment score (SOFA), invasive/noninvasive mechanical ventilator days, length of stay in the hospital and intensive care unit, inotropic requirement, and 28-day mortality, were retrospectively scanned and recorded. Results: Advanced age, lower BMI, higher Charlson Comorbidity index (CCI), SOFA score, and CFS increased 28-day mortality. CFS was found to be associated with 28-day mortality similar to the use of inotropic agents, prolonged MV duration, and ICU length of stay (LOS). Conclusions: CFS is effective in predicting 28-day mortality in geriatric patients diagnosed with pneumonia in intensive care. It also provides insights into morbidity parameters such as requirement for inotropic agents, duration of mechanical ventilation (MV), and LOS ICU.

Background and Objectives: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may cause acute respiratory failure, but also remains responsible for many other pathologies, including electrolyte disorders. SARS-CoV-2 infection causes disorders in many systems and can disrupt water homeostasis with thirst and appetite abnormalities. Dysnatremia affects prognosis, and may be associated with mortality in patients admitted to an intensive care unit (ICU) diagnosed with SARS-CoV-2. Materials and Methods: The study included 209 patients admitted to the ICU between 12 April 2021 and 1 March 2022 who were over 18 years old and diagnosed with SARS-CoV-2 infection by clinical and thoracic tomography findings or with a positive reverse transcription polymerase chain reaction (RT-PCR) test result. The laboratory markers, treatment modalities, nutritional, and respiratory support also for outcome evaluation, length of stay in the ICU, total hospitalization duration, and mortality in the ICU were recorded. The laboratory marker comparison was made using admission with the final assessment performed before the time of mortality in the ICU or after discharge. Results: Inotropic requirements among patients were high, which reflected mortality in the ICU. Hypernatremia presence was associated with an increase in enteral support, the inotropic support requirement, and mortality. Hypernatremia was correlated with diabetes mellitus, chronic renal failure, and a longer duration under mechanical ventilation. Conclusions: Hypernatremia was an important risk factor in ICU patients hospitalized for SARS-CoV-2 infection, which was also affected by the treatment regimens given themselves. This complex relationship underlies the importance of proper electrolyte management, especially in patients who were under severe stress and organ failure.

In this study, we aimed to compare the effects of two different local anesthetics with different baricity used in spinal anesthesia on thermoregulation. Our study was conducted on forty full-term pregnant women scheduled for elective cesarean sections under spinal anesthesia. At an operating room temperature of twenty-four degrees Celsius, peripheral body temperature was measured using temperature probes attached to the lower medial parts of the same side’s lower and upper extremities, and central body temperature was measured with a tympanic thermometer. Isobaric levobupivacaine and hyperbaric bupivacaine were used in spinal anesthesia applications. After spinal anesthesia, tympanic temperature, arm and leg temperatures, mean arterial pressure, heart rate, and oxygen saturation were measured and recorded at baseline, the first, third, and fifth minutes, and every five minutes thereafter until the end of surgery. In the bupivacaine group, a decrease in tympanic temperature was observed at the third minute and an increase in leg skin temperature at the fifth minute compared to baseline values. In the levobupivacaine group, a decrease in tympanic temperature was observed at the fifth minute, and an increase in leg skin temperature was observed at the third minute. In both groups, within-group comparisons showed a continued decrease in tympanic temperature and increase in leg temperature at all subsequent time points compared to baseline. No statistically significant difference was observed in arm skin temperatures within groups in either group. We observed that the effects of hyperbaric bupivacaine and isobaric levobupivacaine used in spinal anesthesia on thermoregulation were similar.

Background and Aim: Frailty can represent the transitional stage between successful aging and old age in need of care; it is a guide for setting goals for regaining robust old age in the individual at risk. Frailty is associated with longer intensive care unit duration, hospital stay, and higher mortality.The aim of this study was to evaluate the relationship between mortality and frailty in geriatric patients (65 years and older) admitted to the intensive care unit with a diagnosis of pneumonia. Methods: 478 patients were included in the study. The demographic data such as age, gender, body mass index(BMI), Charlson Comorbidite Index(CCI), Clinical Frailty Scale (CFS), Acute Physiology and Chronic Health Evaluation (APACHE II) scores, Sequential Organ Failure Assessment Score (SOFA), invasive/noninvasive mechanical ventilator days, length of stay hospital and intensive care unit, inotropic requirement, and 28-day mortality were retrospectively scanned and recorded. Results: Advanced age, lower BMI, higher Charlson Comorbidity Index (CCI), SOFA score, and CFS increase 28-day mortality. CFS was found to be associated with 28-day mortality similar to the use of inotropic agents, prolonged MV duration, and ICU length of stay (LOS). Conclusion: CFS is effective in predicting 28-day mortality in geriatric patients diagnosed with pneumonia in intensive care. It also provides insights into morbidity parameters such as, requirement for inotropic agents, duration of mechanical ventilation (MV), and LOS ICU.

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may cause acute respiratory failure but also remains responsible for many other pathologies, including electrolyte disorders. SARS-CoV-2 infection can cause dysfunction of the renin-angiotensin-aldosterone system and disrupt water hemostasis with thirst and appetite abnormalities. Dysnatremia affects prognosis and may be associated with mortality in patients admitted to SARS-CoV2 intensive care. Patients and Methods: The study included 209 patients admitted to the Intensive Care Unit between April 12, 2021, and March 1, 2022 who were over 18 years old and diagnosed with SARS-CoV-2 infection by clinical and thoracic tomography findings or with a positive reverse transcription polymerase chain reaction (RT-PCR) test result. The laboratory markers, treatment modalities, nutritional, and respiratory support also for outcome evaluation, length of stay in the ICU, total hospitalization duration, and mortality in ICU were recorded.The laboratory marker comparison was made admission with the final assessment performed before the time of mortality in ICU or discharge. Results: Inotropic requirements among patients were high which was reflected in the first-month mortality. Hypernatremia presence was associated with an increase in enteral support and inotropic support requirement and mortality. Hypernatremia was correlated with diabetes mellitus, chronic renal failure, and a longer duration under mechanical ventilation. Discussion: Hypernatremia was an important risk factor in ICU patients hospitalized for SARS-CoV-2 infection, which was also affected by the treatment regimens given itself. This complex relationship underlies the importance of proper electrolyte management, especially in patients who were under severe stress and organ failure.