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Öğe Correlation between serum triglyceride to HDL cholesterol ratio and blood pressure in patients with primary hypertension(Wiley, 2022) Kurtkulagi, Ozge; Aktas, Gulali; Duman, Tuba Taslamacioglu; Bilgin, Satilmis; Tel, Burcin Meryem Atak; Kahveci, GizemHypertension (HT) is associated with significant morbidity and mortality. The efficacy of the treatment in HT patients is mostly depending on the office or home blood pressure monitoring. Triglyceride to high density lipoprotein (HDL) cholesterol ratio (THR) is an inflammatory and metabolic predictor. We aimed to compare THR levels of the HT patients with poorly controlled blood pressure levels to those with well-controlled hypertensive subjects. In present cross sectional study, we grouped patients with HT either as well or poorly controlled hypertensive subjects according to the blood pressure measurement. THR of the groups compared. The THR of the poorly controlled HT group (3.9 [1.91-88.7]%) was significantly higher than the THR of the well-controlled HT group (3.07 [0.71-35.8]%), (p < .001). The sensitivity and specificity of THR higher than 3.26% in predicting poor blood pressure control were 72% and 52%, respectively (AUC: 0.64, p <.01, %95 CI: %59-70). High THR levels in HT patients may warrant closer monitorization of blood pressure since it may predict poor blood pressure control in this population.Öğe Development of a novel clinical prediction model for sepsis related mortality by combining NEWS, PIRO and lactate(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2025) Kurtkulagi, Ozge; Cetin, Ece Unal; Kamis, Fatih; Das, Murat; Simsek, Esen; Kurtkulagi, Ozgur; Cetin, Adil UgurPrognostic assessment plays a crucial role in guiding therapeutic decision-making for patients with sepsis, particularly in intensive care settings. This study aimed to develop a multivariable model to predict 28-day mortality among intensive care unit (ICU) patients with sepsis by integrating serum lactate levels, the National Early Warning Score (NEWS), and the Predisposition, Infection, Response, and Organ Dysfunction (PIRO) score. Demographic information, clinical characteristics, and laboratory findings routinely collected at ICU admission were used to calculate the NEWS and PIRO scores for each patient. Patients were categorized as survivors or non-survivors based on their outcome. Both logistic regression and Cox proportional hazards models were applied for mortality prediction analysis. The final analysis included 205 patients diagnosed with sepsis (mean age: 73.6 +/- 13.2 years; 53.2% male), of whom 109 died during hospitalization. Logistic regression analysis revealed that lactate, NEWS, and PIRO scores were independently associated with 28-day mortality. Combining lactate levels with NEWS and PIRO significantly enhanced mortality prediction, with the greatest accuracy observed when all three parameters were integrated. Pairwise analyses demonstrated that adding lactate to the base model significantly improved predictive accuracy (DBA: -0.103, p = 0.003), and incorporating lactate into a model already including NEWS further enhanced its predictive value (DBA: -0.042, p = 0.037). In conclusion, serum lactate measured at initial ICU admission provides valuable prognostic information for predicting 28-day mortality in sepsis patients. Furthermore, combining lactate levels with NEWS and PIRO scores substantially enhances the accuracy of mortality prediction in these patients.Öğe ICU admission delays: Impact on length of stay and long-term outcomes(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2026) Aydemir, Ferhan Demirer; Kurtkulagi, Ozge; Ergun, Bisar; Bayrak, Vecihe; Oner, Ozlem; Comert, Bilgin; Gokmen, Ali NecatiDelays in intensive care unit (ICU) admissions are prevalent in overcrowded hospitals and can adversely affect patient outcomes. However, the extent of this impact, particularly beyond short-term mortality, remains unclear. We hypothesized that ICU admission delays exceeding 6 hours after consultation would independently increase 90-day mortality and prolong ICU length of stay. We conducted a retrospective analysis of data from 273 adult patients admitted to the ICU of a tertiary university hospital between January and December 2019. Patients were stratified into two groups: early admission (<= 6 hours) and delayed admission (>6 hours). Multivariate Cox regression was employed to identify independent predictors of mortality. Delayed ICU admission was observed in 72.8% of patients. Although delayed admission was not independently associated with increased mortality in the multivariate analysis (HR: 0.88; 95% CI: 0.61-1.27), it was significantly correlated with prolonged ICU length of stay and higher 90-day mortality in the univariate analysis (p = 0.039), with no significant difference in vasopressor-free days (p = 0.809). In our assessment of independent mortality predictors, we found that patients with higher APACHE-II and Charlson scores experienced longer delays in ICU transfer. Additionally, respiratory and circulatory failure at admission were independently associated with increased mortality (HR: 2.17; 95% CI: 1.51-3.12). While early ICU admission did not independently predict mortality, it was linked to extended ICU stays, an increased treatment burden, and adverse long-term outcomes. These findings underscore the necessity of refining triage processes and evaluating baseline patient severity when interpreting the impact of ICU admission timing on outcomes.Öğe Lactate-albumin ratio improves combined predictive value of qSOFA and MEWS for 30-day mortality in ICU patients with sepsis: A retrospective cohort study(Lippincott Williams & Wilkins, 2025) Unal Cetin, Ece; Kurtkulagi, Ozge; Kamis, Fatih; Das, Murat; Simsek, Esen; Cetin, Adil Ugur; Demirer Aydemir, FerhanEvaluating disease severity and predicting adverse outcomes using various risk prediction tools in early disease stages is essential to reduce sepsis-related mortality. Unfortunately, there is still no clear consensus on the best score. The present study aimed to develop and validate a multivariable risk prediction model for 30-days mortality by combining the lactate-to-albumin (L/A) ratio, Modified Early Warning Score (MEWS), and quick Sequential Organ Failure Assessment (qSOFA) in sepsis patients admitted to the intensive care unit (ICU). This retrospective study included ICU patients with suspected sepsis. We computed L/A ratio, MEWS, and qSOFA within 24 hours of ICU admission. Patients were followed until either death/hospital discharge or 30 days, whichever came first. The predictive performance of each scoring system and their combinations was assessed using logistic regression and receiver operating characteristic curve analyses. A total of 130 patients with sepsis admitted to the ICU were included in the study. The mortality rate was 63.07% (82/130). A higher L/A ratio, MEWS, and qSOFA were found to be associated with mortality in ICU sepsis patients. A statistically significant difference in terms of predicting mortality was demonstrated in the pairwise comparison after combining the L/A ratio with both the qSOFA and MEWS (difference between areas: -0.098, P = .011 and difference between areas: -0.098, P = .013 respectively). Mortality models combining L/A ratio with selected clinical variables have improved mortality prediction performance compared with models that use MEWS and qSOFA alone. The L/A ratio at ICU admission provide valuable prognostic information for predicting 30-days mortality in sepsis patients. Combining these ratio with MEWS and qSOFA improves the accuracy of predicting mortality in patients with sepsis.
