The objectives of this study are to assess the chest drainage volumes of patients undergoing anatomic resection of non-small cell lung carcinoma and to determine the safety and effectiveness of administering enoxaparin for thromboprophylaxis. A total of 77 patients were included in the study. A study was conducted on the first group of 42 patients in which enoxaparin prophylaxis (enoxaparin, 40 mg) was subcutaneously injected once a day for a period of three days after the patients underwent anatomic pulmonary resection between March 2016 and March 2018. An enoxaparin-free group was identified and included 35 patients who received no enoxaparin prophylaxis after undergoing anatomic pulmonary resection between February 2013 and February 2016. We compared the changes in hemoglobin (Hb) levels, postoperative 3-day drainage volume, transfusion volume, pulmonary complications and length of stay between the two groups. No differences in postoperative Hb levels, chest drainage volume, transfusion volume, postoperative complications, and length of stay were observed between the two groups. Deep-vein thrombosis was noted in a patient in the enoxaparin-free group. No major bleeding was noted in either group. We found that for patients undergoing anatomic resection of primary lung cancer, the blood transfusion and chest drainage volumes did not differ, regardless of whether the patients were given enoxaparin. To the best of our knowledge, the impact of low-molecular-weight heparin on chest tube drainage volume for patients undergoing anatomic resection of non-small cell lung carcinoma has not been investigated before.

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.

Background and Objectives: Thoracic trauma usually results in high morbidity and mortality. It is the leading cause of death in patients within the first four decades of life. In this study, we aimed to identify risk factors for intensive care mortality and to evaluate factors affecting clinical outcomes and complications in patients with thoracic trauma who were treated in the intensive care unit (ICU). Materials and Methods: This was a retrospective, single-center study. Patients diagnosed with thoracic trauma and followed up in the ICU between 1 May 2023 and 1 January 2025 were included. Critically ill patients aged 18 years and older whose admission blood values were available and who had undergone radiological imaging were included in the study. Patients were grouped as Survivors or Non-survivors. The primary outcome was to determine risk factors for mortality. The secondary outcome was to evaluate factors affecting clinical outcomes and complications. The tertiary outcome was to determine the predictive value of the Injury Severity Score (ISS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Glasgow Coma Scale (GCS) for mortality. Results: A total of 104 patients (male/female ratio: 76/28) were included in the study. Twenty-four patients (23.1%) died, and eighty (76.9%) were discharged. Age in the Non-survivor group was found to be significantly higher (59.33 ± 22.21 vs. 40.50 ± 17.71; p < 0.001), and the proportion of women was also significantly higher in the Non-survivor group (p = 0.0082). Mortality was associated with advanced age, female sex, lower GCS score (p < 0.001), higher APACHE II scores (p < 0.001), and the presence of comorbid conditions (p = 0.003), including head trauma (p = 0.024) and cardiac arrest before ICU admission (p = 0.011). The Non-survivor group more frequently required mechanical ventilation (p < 0.001), vasopressor support (p < 0.001), and continuous renal replacement therapy (p < 0.001), and they developed ventilator-associated pneumonia (p < 0.001) and acute respiratory distress syndrome (p < 0.001) at higher rates. ICU length of stay was also significantly longer in the Non-survivor group (p = 0.045). The APACHE II score demonstrated the highest discriminatory performance, emerging as the strongest clinical predictor of mortality (AUC = 0.751, 95% CI: 0.630–0.872; p < 0.001). Age (OR: 1.06) and serum lactate levels (OR: 1.57) consistently emerged as strong independent predictors of mortality. The presence of head trauma significantly increased the risk of mortality, particularly in the APACHE II-adjusted model (OR: 9.08). The APACHE II–based model yielded high specificity (96.3%) and accuracy (88.5%), with good discrimination (AUC = 0.894) and the highest Nagelkerke R² (0.548). Conclusions: Factors that may shorten the length of ICU stay include infection control, early correction of acidosis, and maintenance of hemodynamic stability, which may reduce mortality. APACHE II was more closely related to overall clinical severity than the other scoring systems. Our data indicate that age-related frailty and acute physiological derangement, as best represented by the APACHE II score, are more significant determinants of survival than anatomic injury severity alone.

Background/Objectives: Surgical resection remains an important treatment option for selected patients with bronchiectasis who have persistent symptoms, recurrent pulmonary infections, or hemoptysis despite medical therapy. This study evaluated perioperative and follow-up outcomes after pulmonary resection for bronchiectasis in a predominantly video-assisted thoracoscopic surgery (VATS)-treated cohort. Methods: This retrospective single-center cohort included patients who underwent pulmonary resection for bronchiectasis between January 2009 and January 2026. Baseline and follow-up data were analyzed at the patient level, whereas operative and perioperative outcomes were assessed at the procedure level. Follow-up duration was calculated from the most recent resection to the last available clinical assessment. Results: Thirty-four patients underwent 37 pulmonary resections. Multilobar disease was present in 14 procedures (37.8%). VATS was used in 30 procedures (81.1%) and thoracotomy in 7 (18.9%). Median hospital stay was 11 days (range, 4–41). Postoperative complications occurred after 6 procedures (16.2%), with no 30-day mortality. Complete or partial symptomatic improvement occurred after 31 procedures (83.8%). Median follow-up was 20.8 months (interquartile range, 5.9–58.8; range, 0.4–144.2). At the last available clinical assessment, 23 patients (67.6%) had no recorded symptoms; recurrent hemoptysis occurred in 1 (2.9%) and recurrent pulmonary infection in 2 (5.9%). Conclusions: Pulmonary resection for bronchiectasis was associated with acceptable morbidity, no 30-day mortality, and a high rate of postoperative clinical improvement in this VATS-dominant cohort. Most patients had no recorded symptoms at their last available clinical assessment, while recurrent hemoptysis and pulmonary infection were uncommon.

Objective: Early treatment failure following initial tube thoracostomy remains a major clinical challenge in patients with first-episode primary spontaneous pneumothorax (PSP). This study aimed to identify clinical predictors of early treatment failure and evaluate its association with short-term clinical outcomes.Materials and Methods: This retrospective single-center study included 80 consecutive patients with first-episode PSP treated with initial tube thoracostomy between January 2014 and January 2026. Early treatment failure was defined as persistent air leak 48 hours after tube insertion despite a functioning drainage system. Demographic, laboratory, and radiological variables were analyzed using univariable and multivariable binary logistic regression. Receiver operating characteristic (ROC) analysis was performed for continuous variables.Results: Early treatment failure occurred in 39 patients (48.8%). In univariable analysis, blebs and/or bullae (OR 4.455, 95% CI 1.530–12.969; p=0.006) and residual pneumothorax on the first-day chest radiograph (OR 2.875, 95% CI 1.148–7.200; p=0.024) were significantly associated with early treatment failure. After multivariable adjustment, only the neutrophil-to-lymphocyte ratio remained independently associated (OR 2.201, 95% CI 1.088–4.452; p=0.028). Early treatment failure was associated with prolonged air leak, increased VATS requirement, longer chest tube duration, and longer hospital stay (all p

Background: Pediatric pulmonary resections are performed for a wide spectrum of congenital, infectious, and neoplastic diseases; however, clinical outcomes and surgical approaches remain subjects of ongoing evaluation. Aims: To evaluate the indications, surgical techniques, and clinical outcomes of pediatric pulmonary resections. Study design: A retrospective, single-center case series. Methods: Medical records of 41 pulmonary resection procedures performed in pediatric patients were reviewed retrospectively. Data on demographic characteristics, type of resection, laterality, pathological diagnoses, and postoperative outcomes were analyzed. Results: Wedge resection was the most frequently performed procedure (75.6%), while bullous emphysema was the most common pathological diagnosis (51.2%). Of all resection procedures, 86.1% were associated with benign and 13.9% with malignant conditions. No major postoperative complications and no 90-day mortality were documented in the reviewed records. During follow-up, three patients died, all of whom had malignant diagnoses. Conclusion: In this retrospective single-center mixed-pathology case series, pediatric pulmonary resections were associated with favorable observed perioperative outcomes, with no documented major postoperative complications or 90-day mortality. Operative strategy was individualized according to lesion type, extent, and surgical feasibility, while follow-up deaths were confined to patients with malignant diagnoses.