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  • Küçük Resim
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    Investigating neutrophil-to-eosinophil ratio and variations in eosinophil levels in epilepsy patients with generalized tonic-clonic seizures
    (2020) Gunes, Muzaffer
    Aim: Neutrophil-to-eosinophil ratio (NER) shows inflammation, which can play a role in the development of some epilepsies and ictogenesis. The current study aimed to investigate the NER and the variations in neutrophil and eosinophil levels in epilepsy patients with generalized tonic-clonic seizures.Material and Methods: Epilepsy patients with generalized tonic-clonic seizures were retrospectively evaluated in the present study. Laboratory parameters of the patients in the acute (within 6 hours after the seizure) and subacute (on day 5 after the seizure) phases were compared.Results: 60 patients (30 males and 30 females) who had generalized tonic-clonic epileptic seizures were included in the study. The median neutrophil count and NER were significantly higher in the acute phase than in the subacute phase (p0.001). The median C-reactive protein and eosinophil values and the mean lymphocyte count were significantly lower in the acute phase than in the subacute phase (p0.001). Conclusions: NER can be used as a new potential biomarker of systemic inflammation that triggers seizures in generalized tonic-clonic epileptic seizures. Further studies are needed for the role of NER in epilepsy and epileptic seizures.
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    Investigation of the predictive factors for mortality in patients undergoing decompressive craniectomy: A retrospective cross-sectional study
    (2022) Ozeren, Ersin; Gunes, Muzaffer
    Aim: Malignant middle cerebral artery (MCA) infarctions and severe traumatic brain injuries (TBI) can cause increased intracranial pressure (ICP), herniation, and eventually lead to death. Decompressive craniectomy (DC) can be life-saving in these patients. The present study aims to investigate the predictive factors for mortality in patients undergoing DC due to malignant MCA infarction and severe TBI. Material and Methods: Between January 2015 and January 2020, clinical and imaging findings, demographic characteristics and laboratory results of patients who underwent DC due to severe TBI and malignant MCA infarction were retrospectively analyzed and recorded for statistical analysis. In order to identify the most significant parameter in relation to mortality, a receiver operating characteristic (ROC) analysis was performed, and the area under the ROC curve was calculated. Results: The study included 30 patients undergoing DC. Out of 12 patients with TBI and 18 with malignant MCA infarction, 6 (50%) and 15 (83.3%), respectively, died. There was no statistically significant difference between survivors and non-survivors in terms of age and gender (p = 0.625 and p = 0.626). Patients who did not survive had significantly lower Glasgow coma scale (GCS) scores than survivors (p = 0.001). Moreover, the degree of midline shift, C-reactive protein-to-albumin ratio (CAR) and red blood cell distribution width (RDW-SD) levels were significantly higher in non-survivors than in survivors (p = 0.017, p = 0.002, and p = 0.009, respectively). The AUC values were as follows: GCS = 0.876 (95% Confidence Interval (CI), 0.733-1), CAR = 0.844 (95% CI, 0.706-0.982), RDW-SD = 0.796 (95% CI, 0.637-0.955), and amount of shift 0.775 (95% CI, 0.602-0.948). Conclusion: The present study found that patients with low GCS, an increased degree of midline shift, and high CAR and RDW-SD values benefit less from DC. It was considered that high CAR and RDW-SD could be a predictive marker for mortality.
  • Küçük Resim
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    Vascular mortality rates and effects of hematological inflammatory markers on in-hospital mortality in patients with acute ischemic stroke
    (2021) Gunes, Muzaffer
    Aim: Inflammatory markers that may be associated with on the prognosis of acute ischemic stroke (IS) such as C-reactive protein/albumin ratio, neutrophil/lymphocyte ratio, albumin, red blood cell distribution width (RDW) have been investigated in the recent years. In this study, it was aimed to investigate the effects of all these inflammatory markers on in-hospital mortality and to determine the mortality rates due to cerebral artery occlusion in patients with acute IS. Materials and Methods: Patients hospitalized in our hospital with a diagnosis of acute IS between April 2014 and August 2018 were retrospectively analyzed. Logistic regression analysis was used to investigate the prognostic factors in IS. Receiver operating characteristic (ROC) curve analysis was performed to calculate the cut-off values and evaluate the predictive values of variables. Results: 344 patients, including 267 patients who were alive and 77 patients who died at the hospital, were included in the study. The infarcts that had the highest mortality rate were massive infarcts in the internal carotid artery area (75%), middle cerebral artery-M1 segment infarctions (62.5%) and total basilar artery infarcts (40%). According to the multivariate logistic regression model, only RDW-SD and albumin were found to be poor prognostic factors of IS (p=0.005 and p=0.021). Area under the ROC curve was as follows: RDW-SD 0.613 (95% CI, 0.53-0.69).Conclusions: High RDW-SD and low albumin levels at admission are independent poor prognostic factors of acute IS. Multicenter studies conducted with large patient populations are necessary to determine vascular mortality rates in patients with IS.