Yazar "Gunen H." seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Prognostic role of simplified pulmonary embolism severity index and the European society of cardiology prognostic model in short- and long-term risk stratification in pulmonary embolism
    (Professional Medical Publications, 2014) Kilic T.; Gunen H.; Gulbas G.; Hacievliyagil S.S.; Ozer A.
    Objectives: Hemodynamic status, cardiac enzymes, and imaging-based risk stratification are frequently used to evaluate a pulmonary embolism (PE). This study investigated the prognostic role of a simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods: The study included 50 patients from the emergency and pulmonology department of one medical center between October 2005 and June 2006. The ability of the sPESI and ESC model to predict shortterm (in-hospital) and long-term (6-month and 6-year) overall mortality was assessed, in addition to the accurancy of the sPESI and ESC model in predicting short-term adverse events, such as cardiopulmonary resuscitation, or major bleeding. Results: Of the 50 patients, the in-hospital and 6-year mortality rates were 14% and 46%, respectively. Fifteen (30%) of these experienced adverse events during hospitalization. Importantly, patients classified as low-risk according to the sPESI had no short-term adverse events as opposed to 4.8% in the ESC low-risk group. They also had no in-hospital, 6-month, or 6-year mortality compared to 4.8%, %14.3, and %23.8, respectively, in the ESC low-risk group. Conclusions: The sPESI predicted short-term and long-term survival. The exclusion of short-term adverse events does not appear to require imaging and laboratory testing. © 2014 Professional Medical Publications. All right reserved.
  • Küçük Resim Yok
    Öğe
    Spirometric predictors for the exclusion of severe hypoxemia in chronic obstructive pulmonary disease
    (Hindawi Limited, 2001) Gunen H.; Kosar F.
    Background: Controversy has existed over the need for routine arterial blood gas (ABG) analysis in patients with chronic obstructive pulmonary disease (COPD). Some authors recommended it in all patients with COPD, but others find it unnecessary if the forced expiratory volume in 1 s (FEV1) is 50% of predicted or greater. Objectives: To clarify this controversy, and to investigate correlations between severe hypoxemia and multiple spirometric parameters in patients with COPD with FEV1 50% of predicted or greater. Patients and methods: In 103 consecutive patients with COPD with FEV1 50% of predicted or greater, and without any other cardiopulmonary disorder, the incidence of severe hypoxemia (partial pressure of arterial oxygen less than 60 mmHg) was established by ABG analysis. Positive and negative predictive values (PPVs and NPVs, respectively) for severe hypoxemia for multiple spirometric parameters (FEV1,FEV1/forced vital capacity [FVC], peak expiratory flow [PEF], maximal midexpiratory flow rate [FEF25-75]) were evaluated in a stepwise manner. Results: Twenty-two patients (21%) were found to be severely hypoxemic. In the severely hypoxemic group, the mean values for FEV1, FEV1/FVC, PEF and FEF25-75 were 59.0±8.19%, 53.6±11.3, 50.6±9.3 and 34.4±14.2% of predicted, respectively. The mean values for the same parameters in the other patients were 58.0±4.6%, 52.7±7.8, 51.5±7.5 and 39.1±7.7% of predicted, respectively. Comparing these parameters between the two groups, only the difference in FEF25-75 was statistically significant (P<0.01). Valid PPVs and NPVs could not be established for any of the parameters at any level, except for the NPV for FEF25-75 50% of predicted or greater, which was 92%. This threshold value resulted in a false negative finding in less than 5% of the patients with hypoxemia. Conclusions: The results of the present study showed that one in five patients with COPD with FEV1 50% of predicted or greater was severely hypoxemic. In such patients, hypoxemia may be excluded, and ABG analysis may not be needed when the FEF25-75 is also 50% of predicted or greater. The FEV1, FEV1/FVC and PEF parameters failed to predict or exclude severe hypoxemia.