Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluateasthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and ≥60 (elderlyasthma) years of age.Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item MoriskyMedication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed.Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%)were female. The age at asthma diagnosis was ≥60 in 146 (36.6%) patients. Patients diagnosed ≥60 years were older (p < 0.001), hadhigher education level (p < 0.001), more commonly had first-degree relative with asthma (p = 0.038), asthma related comorbidities(p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controllermedications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatmentcompliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well-controlledasthma (odds ratio = 1.61, CI = 1.04–2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48–4.0) were associated withbeing in the elderly asthma group.Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age ofasthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better.Patients diagnosed ≥60 years of age did not have more severe disease.
Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates.
Introduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up. Materials and Methods: This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017. The clinical research was planned as observational, multicenter, cross-sectional. Results: A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the "0" the worst probability "5" being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r: -0.488; p< 0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% Cl: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively. Conclusion: In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician's opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters.