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    Advancing ICU mortality prediction in community-
    (Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2025) Cetin, Ece Unal; Kurtkulagi, Ozge; Kamis, Fatih; Das, Murat; Simsek, Esen; Cetin, Adil Ugur; Beyazit, Yavuz
    Community-acquired pneumonia (CAP) is a leading cause of ICU admissions, with significant morbidity and mortality. Traditional risk stratification tools such as CURB-65, the Pneumonia Severity Index (PSI), and CT severity scores (CT-SS) are widely used for prognosis but could be improved by incorporating novel biomarkers. This retrospective study evaluated the fibrinogen-to-albumin ratio (FAR) as an additional predictor of 30-day mortality in ICU patients with CAP. A total of 158 CAP patients admitted to a tertiary care ICU were included. Baseline data encompassed demographic, clinical, laboratory, and radiological parameters, including FAR, CURB-65, PSI, and CT-SS. Logistic regression and ROC curve analyses were conducted to assess mortality predictors. The 30-day mortality rate was 70.88% (112/158). Higher FAR, PSI, CURB-65, CT-SS, and lactate levels were independently associated with increased mortality (p < 0.05). FAR demonstrated strong discriminatory power (AUROC: 0.704) and significantly improved the predictive accuracy of established models. Adding FAR to PSI increased the area under the receiver operating characteristic (AUROC) from 0.705 to 0.791 (p = 0.009), while combining FAR, CT-SS, and PSI yielded the highest predictive accuracy (AUROC: 0.844, p = 0.032). These findings suggest that FAR, which reflects both inflammation and nutritional status, complements traditional risk assessment tools by providing a dynamic perspective. Integrating FAR into existing models enhances the identification of high-risk patients, enabling timely interventions and more efficient resource allocation in the ICU.
  • [ X ]
    Öğe
    Clinical Characteristics of Patients Diagnosed with Synthetic Cannabinoid (Bonsai) Intoxication in Intensive Care Unit
    (Galenos Yayincilik, 2015) Altinisik, Ugur; Altinisik, Hatice Betul; Simsek, Tuncer; Dogu, Tugba; Simsek, Esen; Aydin, Halide
    Objective: In recent years, synthetic cannabinoids (bonsai) poisoning is a widely seen case that needs to be treated in intensive care unit (ICU) in our country. In this study, it was aimed to discuss the clinical characteristics of patients diagnosed with synthetic cannabinoid intoxication followed in ICU. Material and Method: Patients followed in ICU of Canakkale Onsekiz Mart University and Canakkale State Hospital between 2014 and 2015 were studied retrospectively. Results: Twelve cases were included. In neurological system; confusions (n=4), drowsiness (n=7), restlessness/agitations (n=5), hallucinations (n=2), anxieties/panics (n=3), acute psychosis (n=1) and amnesias (n=11) were detected. One patient was intubated. In cardiovascular system; tachycardias (n=3), bradycardias (n=2), hypertensions (n=2), hypotension (n=1), and arrhythmias (n=2) were observed. In laboratory tests, leukocytosis (n=4), leukopenia (n=1), hypoglycemias (n=3), elevation in liver and renal function tests (n=1) were identified. The average recovery time was 19.3-hours and the average ICU stay was 3-days. Conclusion: In the synthetic cannabinoid intoxication cases; it should be kept in mind that seizure activities may occur in the first hours, myocardial infarction risk in the first 3-days. Liver-kidney functions should be monitored. Hypopotasemia is the most common electrolyte disorder. Cases without any complication are expected to recover in 24-hours. However, new types of synthetic cannabinoids are put on the market every day.

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