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    Factors affecting survival of hospitalised patients with COPD
    (European Respiratory Soc Journals Ltd, 2005) Gunen, H; Hacievliyagil, SS; Kosar, F; Mutlu, LC; Gulbas, G; Pehlivan, E; Sahin, I
    Factors determining in-hospital mortality and long-term survival of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood. The aim of the present study was to assess the parameters related to in-hospital mortality and long-term survival after hospitalisation of patients with AECOPD. Clinical and epidemiological parameters on admission in 205 consecutive patients hospitalised with AECOPD were prospectively assessed. Patients were followed-up for 3 yrs. Factors determining short- and long-term mortality were analysed. In total, 17 patients (8.3%) died in hospital. In-hospital mortality was significantly associated with lower arterial oxygen tension (Pa,O-2), higher carbon dioxide arterial tension, lower arterial oxygen saturation and longer hospital stay. The overall 6-month mortality rate was 24%, with 1-, 2- and 3-yr mortality rates of 33%, 39% and 49%, respectively. Cox regression analysis revealed that long-term mortality was associated with longer disease duration (relative risk (RR)=1.158), lower albumin (RR=0.411), lower Pa,O-2 (RR=0.871) and lower body mass index (RR=0.830). When the model was run for the time elapsed since first hospitalisation, it also appeared as statistically significant (RR=1.195). These findings show that patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease have poor short- and long-term survival. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, disease duration and time elapsed since the first hospitalisation.
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    The role of arterial blood gases, exercise testing, and cardiac examination in asthma
    (Ocean Side Publications Inc, 2006) Gunen, H; Hacievliyagil, SS; Kosar, F; Gulbas, G; Kizkin, O; Sahin, I
    The severity of bronchial asthma may not be assessed easily in some patients using the current evaluation methods. In this study, we aimed to obtain more objective and detailed data in evaluating patients with stable mild and moderate bronchial asthma and to validate the current parameters against more objective ones in determining the disease severity. One-hundred six stable patients with bronchial asthma were included in the study. These patients underwent spirometric and cardiological examination, 6-minute walk testing (6MWT) and arterial blood gas analysis. Continuous measurement of pulse oxymetry (SpO(2)) was done during 6MWT. Dyspnea that developed during 6MWT was measured using the modified Borg category scale. Sixteen patients were found severely hypoxemic at rest, and 16 patients were severely desaturated at 6MWT. Nineteen patients had pulmonary hypertension on echocardiography. Patients with oxygenation problems were older and had longer disease duration, lower forced expiratory flow of 25-75%, higher Borg exercise rating, and higher pulmonary artery pressure (p < 0.05). Patients with pulmonary hypertension had earlier disease onset, lower forced expiratory flow of 25-75%, lower arterial oxygen tension and lower pre-6MWT SpO(2) (P < 0.05), older age, and lower SpO(2) at 6MWT (p < 0.01). Classic evaluation methods correctly operated only on the two-thirds of asthmatic patients. Cardiological examination, 6MWT, and arterial blood gas analysis were needed for the true evaluation of other patients who had potentially progressive disease. We think that evaluation of asthmatic patients with these more objective and detailed methods provides important additional clinical data.
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    Stages of copd, pulmonary function test, anthropometric measurements and relationship with nutrition
    (European journal of publıc health, 2018) Mete, B; Pehlivan, E; Gulbas, G; Gunen, H