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Öğe Bronchial atresia in an adult misdiagnosed as pulmonary mass(Turkish Assoc Tuberculosis & Thorax, 2017) Demir, Melike; Taylan, Mahsuk; Yilmaz, Sureyya; Dursun, Elif; Sezgi, Cengizhan; Isik, Recep[Abstract Not Available]Öğe Cefuroxime Axetil Related DRESS (drug reaction with eosinophilia and systemic symptoms) Syndrome(Modestum Ltd, 2016) Yildirim, Yasar; Kara, A. Veysel; Yilmaz, Zulfikar; Yildirim, Resit; Yilmaz, Sureyya; Kadiroglu, A. Kemal; Yilmaz, M. EminDRESS (Drug reaction with eosinophilia and systemic symptoms) syndrome is a rare, potentially life-threatening, drug induced hypersensitivity reaction manifested by fever, rash, eosinophilia, lymphadenopathy, and organ involvement especially liver and kidney. The disease is characterized by a long latency period (at least two weeks) between the drug exposure and disease onset. The most commonly reported drugs associated with DRESS syndrome in the literature are allopurinol, and anticonvulsants. We describe a patient presented with eosinophilia, fever, diffuse maculopapular rash, hepatomegaly, and multiple intra-abdominal lymphadenopathies just ten days after initiation of cefuroxime axetil. In our case, we aim to announce the first case report of cefuroxime axetil related DRESS syndrome, and also speculate on the possible association between cephalosporin and DRESS syndrome.Öğe Effect of human development index parameters on tuberculosis incidence in Turkish provinces(J Infection Developing Countries, 2016) Taylan, Mahsuk; Demir, Melike; Yilmaz, Sureyya; Kaya, Halide; Sen, Hadice Selimoglu; Oruc, Menduh; Icer, MustafaIntroduction: A country's development level is measured with a quantitative parameter called the human development index (HDI). The present study researched the effects of HDI parameters (such as healthcare standards, income, and education level) on the incidence of tuberculosis. Methodology: HDI data of 36 provinces of Turkey and the tuberculosis surveillance data were obtained from the Ministry of Development and the Ministry of Health, respectively. The associations between the incidence of tuberculosis and other HDI parameters were analyzed. Results: Higher population density (n/km(2)) (CI = 0.05 to 0.40) and higher relapse rate of tuberculosis (CI = 0.36 to 1.48) were identified to be independent predicting factors that increased the incidence of tuberculosis, whereas higher gross national product (CI =- 0.06 to 0.00), the population that holds a green Medicare card(CI=-0.58 to -0.04), increased general practitioners per 100,000 people (CI=-0.66 to -0.01), female population (CI = -0.70 to -0.06), married population (CI = -1.34 to -0.03), were found to be significant negative predicting factors that were relevant to the incidence (protective against tuberculosis). Conclusions: Tuberculosis is a disease that is affected by multiple factors, including the components of HDI. Improvement of income level, facilitation of access to health services via health insurance, urbanization with lower population density strategy, and provision of enough general practitioners may be useful in reducing the incidence of TB' in provinces of developing countries such as Turkey.Öğe EFFECT OF RED CELL DISTRIBUTION WIDTH ON ACUTE KIDNEY INJURY IN PATIENTS WITH METASTATIC LUNG CANCER RDW IN LUNG CANCER PATIENTS WITH KIDNEY INJURY(Carbone Editore, 2019) Aydin, Fatma Yilmaz; Aydin, Emre; Yildirim, Yasar; Yilmaz, Zulfukar; Kara, Ali Veysel; Yilmaz, Sureyya; Kaplan, Muhammet AliIntroduction: Lung cancer is a common malignity with high mortality rate. One of the main reason which affects mortality is acute kidney injury (AKI). Therefore, early diagnosis of AKI is of essential. In our study, we investigated the effects of Red Cell Distribution Width (RDW) on acute kidney injury development in metastatic acute lung cancer patients. Material and methods : The present study was conducted 143 patients with lung malignity at Stage 4 followed up Faculty of Medicine, Dicle University, between 2010- 2015. The study was carried out retrospectively. Creatinine levels, RDW, hemoglobin, Mean Corpuscular Volume ( MCV), C Reaktive protein (CRP), albumin levels as of admission to the intensive care unit (ICU) and after 48 hours, length of stay in ICU and results were recorded. The patients were divided in two groups as RDW > 16,8 and <= 16,8. The groups were examined in terms of acute kidney injury development, mortality and length of stay in intensive care. Results: The study population consists of 122 male (85.3%) and 21 female (14.7%) patients. The average RDW values of the patients is 16.53 +/- 1.91 and RDW >16,8 in 43.4%. AKI development was identified in 60.1% of the patients. The mean age, serum creatinine, AKI and CRP, mortality values were significantly higher and serum albumin, length of stay in intensive care (day) were significantly lower in RDW> 16.8 patient group compared to RDW <= 16.8 patient group. Conclusion: The present study showed that RDW is closely associated with acute kidney injury in advanced lung cancer patients.Öğe Evaluation of Anthropometric and Metabolic Parameters in Obstructive Sleep Apnea(Hindawi Ltd, 2015) Yildirim, Yasar; Yilmaz, Sureyya; Guven, Mehmet; Kilinc, Faruk; Kara, Ali Veysel; Yilmaz, Zulfukar; Kirbas, GokhanAims. Sleep disorders have recently become a significant public health problem worldwide and have deleterious health consequences. Obstructive sleep apnea (OSA) is the most common type of sleep-related breathing disorders. We aimed to evaluate anthropometric measurements, glucose metabolism, and cortisol levels in patients with obstructive sleep apnea (OSA). Materials and Methods. A total of 50 patients with a body mass index >= 30 and major OSA symptoms were included in this study. Anthropometric measurements of the patients were recorded and blood samples were drawn for laboratory analysis. A 24-hour urine sample was also collected from each subject for measurement of 24-hour cortisol excretion. Patients were divided equally into 2 groups according to polysomnography results: control group with an apnea-hypopnea index (AHI) <5 (n = 25) and OSA group with an AHI = 5 (n = 25). Results. Neck and waist circumference, fasting plasma glucose, HbA1c, late-night serum cortisol, morning serum cortisol after 1 mg dexamethasone suppression test, and 24-hour urinary cortisol levels were significantly higher in OSA patients compared to control subjects. Newly diagnosed DM was more frequent in patients with OSA than control subjects (32% versus 8%, p = 0.034). There was a significant positive correlation between AHI and neck circumference, glucose, and latenight serum cortisol. Conclusions. Our study indicates that increased waist and neck circumferences constitute a risk for OSA regardless of obesity status. In addition, OSA has adverse effects on endocrine function and glucose metabolism.Öğe Evaluation of New Biomarkers in the Prediction of Malignant Mesothelioma in Subjects with Environmental Asbestos Exposure(Springer, 2016) Demir, Melike; Kaya, Halide; Taylan, Mahsuk; Ekinci, Aysun; Yilmaz, Sureyya; Teke, Fatma; Sezgi, CengizhanThe purpose of this study was to investigate the potential value of certain biomarkers in predicting the presence of malignant pleural mesothelioma (MPM) in individuals environmentally exposed to asbestos. This prospective study investigated three groups; a control group composed of 41 healthy subjects, an asbestos exposure group consisting of 48 individuals, and a MPM group consisting of 42 patients. Serum levels of soluble mesothelin-related peptide (SMRP), thioredoxin-1 (TRX), epidermal growth factor receptor (EGFR), fibulin-3, syndecan-1 (SDC-1), and mesothelin were determined. Benign pleural plaques were present in 27 (58.3 %) of the individuals in the asbestos exposure group. The asbestos exposure group had significantly higher mean TRX, SMRP, and mesothelin levels compared to the control group (p = 0.023, p = 0.011, and p < 0.001, respectively). Compared to the asbestos exposure group, the MPM group had significantly higher mean EGFR, TRX, SMRP, and fibulin-3 levels (p = 0.041, p = 0.023, p = 0.002, and p = 0.001, respectively), and significantly lower mean SDC-1 levels (p = 0.002). Unlike the other biomarkers, SMRP and TRX levels increased in a graded fashion among the control, asbestos exposure, and MPM groups, respectively. Area under the curve values for SMRP and TRX were 0.86 and 0.72, respectively (95 % CI 0.79-0.92 and p < 0.001 for SMRP, and 95 % CI 0.62-0.81 and p < 0.001 for TRX). The cut-off value for SMRP was 0.62 nmol/l (sensitivity: 97.6 %, specificity: 68.9 %, positive predictive value (PPV): 56.2 %, and negative predictive value (NPV): 98.3 %) and for TRX was 156.67 ng/ml (sensitivity: 92.9 %, specificity: 77.6 %, PPV: 41.4 %, and NPV: 92.1 %). The combination of the biomarkers reached a sensitivity of 100 %, but had lower specificity (as high as 27.7 %). Serum biomarkers may be helpful for early diagnosis of MPM in asbestos-exposed cases. SMRP and TRX increased in a graded fashion from the controls to asbestos exposure and MPM groups. These two seem to be the most valuable biomarkers for the diagnosis of MPM, both individually and in combination.Öğe FACTORS ASSOCIATED WITH MORTALITY AMONG TUBERCULOSIS PATIENTS IN SOUTHEAST TURKEY(Carbone Editore, 2015) Yilmaz, Sureyya; Taylan, Mahsuk; Sen, Hadice Selimoglu; Abakay, Ozlem; Demir, Melike; Kaya, Halide; Yilmaz, ZulfukarIntroduction: Tuberculosis (TB) is a disease caused by bacillus mycobacterium tuberculosis. Tuberculosis is a preventable and treatable disease that, despite the rapid advances in active therapy, continues to cause global mortality. In this study, we investigated the risk factors associated with mortality in patients undergoing treatment for TB. Materials and methods: Records of 2,450 tuberculosis patients who were followed-up with in tuberculosis dispensaries in the city of Diyarbakir, southeast Turkey, between January 2005 and December 2011 were reviewed retrospectively. Case definitions and treatment outcomes were classified according to WHO criteria. Results: Of the 2,450 registered TB patients, 1,339 were male (54.7%) and 1,111 were female (45.3%). Their mean age was 32.15 +/- 17.87 years, and 51 (2.1%) of them died. Mortality rates were higher in pulmonary TB (PTB) patients, males, relapse patients, category 2 patients, those >65 years old, TB meningitis patients, and patients who self-administered their therapy. According to Kaplan-Meier analysis, the mortality rates were significantly higher in patients aged >65 years, in those with Category II and in those TB meningitis. The significant independent risk factors for mortality during anti-TB treatment were advanced age, TB meningitis and gastrointestinal TB. Conclusion: Mortality was increased in the elderly, males, those with relapse, and in category II and extrapulmonary TB patients. Based on these data, we suggest that tuberculosis control programs should pay more attention to the high-risk groups determined in the current and previous studies. Treatment regimens for these risk groups should be considered for revision.Öğe LATE-BREAKING ABSTRACT: The effect of volume overload on pulmonary hypertension in hemodialysis patients(European Respiratory Soc Journals Ltd, 2015) Yilmaz, Sureyya; Yildirim, Yasar; Taylan, Mahsuk; Demir, Melike; Yilmaz, Zulfukar; Kara, Aliveysel; Aydin, Fatma[Abstract Not Available]Öğe AN OVERVIEW OF THROMBOLYTIC TREATMENT FOR PULMONARY EMBOLISM: A SINGLE CENTRE EXPERIENCE(Carbone Editore, 2014) Sen, Hadice Selimoglu; Abakay, Ozlem; Sezgi, Cengizhan; Yilmaz, Sureyya; Taylan, Mahsuk; Kaya, Halide; Tanrikulu, Abdullah CetinIntroduction: A massive pulmonary embolism (MPE) has a poor prognosis and high mortality. Thrombolytic therapy is preferred in patients with life-threatening symptoms such as hypotension, cardiogenic shock, and right ventricular failure due to the risk of severe bleeding. Materials and methods: This is a retrospective analysis of patients who were hospitalized with the diagnosis of pulmonary embolism (PE) and given thrombolytic therapy in the chest diseases clinic of a tertiary university hospital between January 2008 and November 2013. Results: The subjects' mean age was 59.54 +/- 13.76 years. Fourteen of 39 patients who were treated with thrombolytic therapy were male (35.89%) and 25 (64.10%) were female. The symptoms experienced by the patients included dyspnea in 39 patients, chest pain in 35 patients, hemoptysis in 6 patients, syncope in 13 patients and cough in 10 patients. Risk factors were advanced age (> 60 years) in 19, immobilization in 19, malignancy in 3, major surgery in 11 patients. The in-hospital mortality analysis showed that 32 patients were discharged and 7 patients died. Four patients died from their pulmonary embolism and 3 patients died because of a major bleeding complication. Conclusions: Pulmonary embolism is a disease that may lead to death within hours secondary to acute right heart failure. Early diagnosis and treatment can be life saving. Thrombolytic therapy has been shown to improve hemodynamic parameters in the early period post-PE. An increased risk of bleeding is one of the most important drawbacks of thrombolytic therapy. Nonetheless, it can be a life-saving therapy in properly selected patients.Öğe PET/CT positive in a case with eosinophilic granuloma(Turkish Assoc Tuberculosis & Thorax, 2015) Demir, Melike; Meteroglu, Fatih; Kaya, Halide; Taylan, Mahsuk; Yenibertiz, Derya; Yilmaz, Sureyya; Senyigit, Abdurrahman[Abstract Not Available]Öğe The protective effects of paricalcitol on renal ischemia reperfusion induced lung injury(European Respiratory Soc Journals Ltd, 2018) Yilmaz, Sureyya; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal; Bahadir, Veysi; Kaplan, Ibrahim; Ketani, Aydin; Yilmaz, Engin Deniz[Abstract Not Available]Öğe Protective Effects of Paricalcitol on Renal Ischemia/Reperfusion-Induced Lung Injury(Sci Printers & Publ Inc, 2021) Yilmaz, Sureyya; Yildirim, Yasar; Kadiroglu, Ali Kemal; Bahadir, Veysi; Aydin, Emre; Aydin, Fatma Yilmaz; Ketani, AydinOBJECTIVE: Acute kidney injury (AKI) is a common and important clinical challenge, and renal ischemia/reperfusion (I/R) injury is the major reason of AKI. Renal I/R can lead to lung injury, which is associated with increased mortality. This study was designed to evaluate whether paricalcitol may protect against lung injury following renal I/R injury via its antioxidant properties. STUDY DESIGN: Rats (n=7 per group) were divided into 4 groups: control, paricalcitol, I/R, and paricalcitol + I/R. Rats received daily intraperitoneal injection of paricalcitol (0.3 mu g/kg) for 5 days in the paricalcitol and paricalcitol + I/R groups. On day 6, rats were subjected to I/R injury (60 minutes of left renal artery occlusion followed by 60 minutes of reperfusion) after right nephrectomy. Renal function tests, oxidant and anti-oxidant parameters, and lung histology of both groups were examined. RESULTS: Pretreatment of rats with paricalcitol in the paricalcitol + I/R group significantly decreased serum urea and creatinine levels as compared with the I/R group (p < 0.05). Malondialdehyde (MDA) and total oxidant status (TOS) levels were significantly increased in serum and lung tissue of the I/R group as compared with the control and paricalcitol groups (p < 0.05). Rats treated with paricalcitol prior to I/R injury exhibited significant reduction in terms of serum and lung tissue TOS and MDA levels and significant increase in terms of serum and lung tissue nitric oxide and total antioxidant capacity levels (p < 0.05). The lung histopathological scores were significantly higher in the I/R group as compared with the paricalcitol + I/R group (p < 0.05). CONCLUSION: Paricalcitol may ameliorate renal I/Rinduced lung injury by attenuating oxidative stress.Öğe Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload(Int Scientific Information, Inc, 2016) Yilmaz, Sureyya; Yildirim, Yasar; Yilmaz, Zulfukar; Kara, Ali Veysel; Taylan, Mahsuk; Demir, Melike; Coskunsel, MehmetBackground: Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. Material/Methods: We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW 3 7%. Spirometry was performed before and after hemodialysis. Results: Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25-75), FEF25-75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25-75, FEF25-75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. Conclusions: Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload.Öğe Relationship between metabolic syndrome and epicardial fat tissue thickness in patients with chronic obstructive pulmonary disease(Aves, 2016) Demir, Melike; Acet, Halit; Kaya, Halide; Taylan, Mahsuk; Yuksel, Murat; Yilmaz, Sureyya; Sezgi, CengizhanObjective: An increase in epicardial fat tissue (EFT) thickness was found to be associated with metabolic syndrome (MS) and ischemic heart disease. MS is a comorbidity of chronic obstructive pulmonary disease (COPD) resulting from the accompanying systemic inflammation. The aim of our study was to investigate the usefulness of EFT thickness to predict MS in COPD patients. Methods: COPD patients admitted to our clinic during January-December 2014 and healthy controls were included in this prospective case-control study. Patients with comorbidities, COPD exacerbation, and malignancies were excluded. Patients and controls were compared in terms of anthropometric measurements, MS-related examination and laboratory findings, pulmonary function tests, and EFT thickness. The correlations between EFT thickness and markers of MS in COPD were evaluated using the Student's t-test and logistic regression analysis. Results: COPD patients and controls were composed of 82 and 84 individuals, respectively. MS was diagnosed in 31 (37.8%) COPD patients. The EFT thickness was significantly higher in COPD patients than in the controls and was also higher in COPD patients with MS than in those without MS (all p<0.001). Each 1-mm increment of EFT raised the risk of MS two-fold (p=0.011, OR=2.08, 95% CI: 1.18-3.68). Increase in triglyceride level (p=0.004, OR=1.02, 95% CI: 1.01-1.03) and reduction in forced vital capacity (p=0.025, OR=0.26, 95% CI: 0.08-0.84) were found to be associated with increased MS risk. The cut-off value for EFT thickness in the prediction of MS in COPD patients was 6.75 mm (sensitivity: 83%, specificity: 65%). Conclusion: EFT thickness is a non-invasive and easily available parameter, which is valuable in the prediction of increased MS risk in COPD patients. Early diagnosis of patients at risk of MS may help to prevent ischemic heart disease in these patients.Öğe The results of OSAS patients in our clinic(European Respiratory Soc Journals Ltd, 2018) Yilmaz, Sureyya; Sen, Haidce Selimoglu; Taylan, Mahsuk; Demir, Melike; Kirbas, Gokhan[Abstract Not Available]Öğe Role of D-Dimer, Fibrinogen and D-Dimer/Fibrinogen Rate in the Diagnosis of Pulmonary Embolism(Duzce Univ, 2016) Yilmaz, Sureyya; Topcu, Fusun; Ates, Gungor; Yildiz, Tekin; Bogatekin, GulhanObjective: The migration of a blood clot from the systemic circulation to pulmonary veins is called pulmonary embolism (PE). Pulmonary embolism is difficult to diagnose. The aim of the present study is to investigate the utility and diagnostic contribution of d-dimer, fibrinogen level, and Ddimer/ Fibrinogen (D/F) rate which are quick, non-invasive, affordable and easily obtainable laboratory tests in PE. Methods: We have evaluated the diagnostic value of D/F rate in 118 patients who were suspected to have PE. Diagnosis of PE was made by computerized tomographic pulmonary angiography. D-dimer level was above normal in all patients. Initially, Wells clinical scoring was applied on the patients and their d-dimer and fibrinogen levels were measured. Results: Seventy seven patients were detected as PE positive (+) and 41 were detected as PE negative (-). Forty-eight of the cases (40.7%) were male; the average age was 49.77 +/- 19.46 (15-86) years. Between PE (+) and PE (-) patients, d-dimer, fibrinogen, and D/F rate median values and standard derivations were detected to be different and statistically significant. Conclusion: According to this study approach to the patients with suspected from PE, D/F ratio is valuable than d-dimer, and fibrinogen level is significantly lower in patients with PE (+) than patients with PE (-).Öğe The role of inflammatory biomarkers in obstructive sleep apnea syndrome(European Respiratory Soc Journals Ltd, 2018) Yilmaz, Sureyya; Sen, Hadice Selimoglu; Taylan, Mahsuk; Demir, Melike; Topcu, Fusun; Senyigit, Abdurrahman; Kirbas, Gokhan[Abstract Not Available]Öğe Serum Apelin 13 Levels in Patients With Pulmonary Embolism(Sage Publications Inc, 2016) Sen, Hadice Selimoglu; Kaplan, Ibrahim; Abakay, Ozlem; Sezgi, Cengizhan; Yilmaz, Sureyya; Taylan, Mahsuk; Abakay, AbdurrahmanIntroduction and Aim: Expression and peptide immunoreactivity of apelin messenger RNA have been described in a variety of tissues, including gastrointestinal tract, adipose tissue, brain, kidney, liver, cardiovascular system, and lungs. This study aimed to investigate the possible involvement of the endogenous apelin in the pathophysiological events that occur in patients with pulmonary embolism (PE). Materials and Methods: In total, 53 patients with PE and 35 healthy volunteers were included the study. This cross-sectional study was conducted at a tertiary care university hospital and among patients diagnosed as having PE. The control group consisted of healthy volunteers who applied to hospital for a routine checkup examination. Serum apelin 13 levels were measured in both the groups and their results were compared. Results: The median ages were 57 and 53 years, and female-male ratios were 30/23 and 20/15, in the PE and control groups, respectively. The mean serum apelin 13 levels were found to be significantly higher in the PE group (76.94 10.70 ng/mL) than in the control group (50.01 +/- 7.13 ng/mL; P < .001). Conclusion: This study demonstrated that apelin 13 levels are elevated in patients with PE. These results suggest that apelin may be a novel biomarker and a potential therapeutic target in patients with acute PE in the future.Öğe Serum bicarbonate level improves specificity of Berlin Sleep Questionnaire for obstructive sleep apnea(Taylor & Francis Ltd, 2020) Dursun, Mazlum; Selimoglu Sen, Hadice; Yilmaz, Sureyya; Demir, Melike; Kirbas, Gokhan; Taylan, MahsukSeveral questionnaires have been developed to assist the diagnostic process in obstructive sleep apnea syndrome (OSAS). Berlin Sleep Questionnaire (BSQ) represents a validated screening tool for OSAS. Totally 450 patients admitted to the Sleep Center at Dicle University Medical Faculty were included prospectively. A risk analysis was performed for presence of OSAS using the BSQ. Arterial blood gas measurements were performed including bicarbonate (HCO3) level. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BSQ for presence of OSAS and severe OSAS were determined. In patients with arterial HCO3>24.94 mEq/L; sensitivity, specificity, PPV and NPV, of the BSQ were 93.04, 57.1, 98.3, and 23.5%, respectively. The addition of arterial HCO(3)value increased the sensitivity of the BSQ in detecting OSAS patients. Although the cost of sleep studies is high for false positives from the BSQ plus arterial HCO3 level, this cost should be compared with the loss of work efficiency and severe healthcare costs of undiagnosed cases in the future. Therefore, finding possible OSAS cases in primary care health centers is important and adding serum HCO3 value to BSQ questionnaire may contribute to this topic.Öğe A Single Imaging Modality in the Diagnosis, Severity, and Prognosis of Pulmonary Embolism(Hindawi Ltd, 2014) Sen, Hadice Selimoglu; Abakay, Ozlem; Cetincakmak, Mehmet Guli; Sezgi, Cengizhan; Yilmaz, Sureyya; Demir, Melike; Taylan, MahsukIntroduction. This study aimed to investigate the currency of computerized tomography pulmonary angiography-based parameters as pulmonary artery obstruction index (PAOI), as well as right ventricular diameters for pulmonary embolism (PE) risk evaluation and prediction of mortality and intensive care unit (ICU) requirement. Materials and Methods. The study retrospectively enrolled 203 patients hospitalized with acute PE. PAOI was calculated according to Qanadli score. Results. Forty-three patients (23.9%) were hospitalized in the ICU. Nineteen patients (10.6%) died during the 30-day follow-up period. Theoptimal cutoff value of PAOI for PE 30th day mortality and ICU requirement were found as 36.5% in ROC curve analysis. The pulmonary artery systolic pressure had a significant positive correlation with right/left ventricular diameter ratio (r = 0.531, P < 0.001), PAOI (r = 0.296, P < 0.001), and pulmonary artery diameter (r = 0.659, P < 0.001). The patients with PAOI values higher than 36.5% have a 5.7-times increased risk of death. Conclusion. PAOI is a fast and promising parameter for risk assessment in patients with acute PE. With greater education of clinicians in this radiological scoring, a rapid assessment for diagnosis, clinical risk evaluation, and prognosis may be possible in emergency services without the need for echocardiography.
