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  • Küçük Resim
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    Comparison of diagnostic scoring systems with imaging methods for the diagnosis of acute appendicitis
    (2020) Birben, Birkan; Sonmez, Bedriye Muge; Er, Sadettin; Ozden, Sabri; Kosa, Murat; Tez, Mesut
    Aim: Acute appendicitis scores have been developed to better analyze the symptoms and signs of acute appendicitis. In this study, we compared the success rates of different scoring systems with imaging methods in the diagnostic confirmation of acute appendicitis.Materials and Methods: Patients aged above 18 years, who presented to the emergency department with right lower quadrant pain and were suspected to have acute appendicitis, were prospectively and observationally evaluated. The demographic characteristics, imaging modalities, Alvarado score, acute inflammatory response score, and adult appendicitis score were assessed.Results: 237 patients, 46.8% female and 53.2% male, mean age of 34±13 (18-95) years. Appendectomy was performed in 144 (61%) patients with a prediagnosis of acute appendicitis. The pathological results were appendiceal cancer in two patients, lymphoid hyperplasia in 12, and acute appendicitis in 130. Imaging methods were found to be more specific than scores, and positive predictive values in scoring systems were more sensitive than imaging methods in the diagnosis of acute appendicitis.Conclusion: There is still no effective and guiding scoring system for the diagnosis of acute appendicitis. Due to the low negative predictive values of the available scoring systems, patients should be evaluated with detailed anamnesis, examination and laboratory findings, and computed tomography should be performed if there is clinical suspicion of acute appendicitis.
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    A practical scoring system to predict mortality in patients with perforated peptic ulcer
    (Bmc, 2015) Menekse, Ebru; Kocer, Belma; Topcu, Ramazan; Olmez, Aydemir; Tez, Mesut; Kayaalp, Cuneyt
    Introduction: The mortality rate of perforated peptic ulcer is still high particularly for aged patients and all the existing scoring systems to predict mortality are complicated or based on history taking which is not always reliable for elderly patients. This study's aim was to develop an easy and applicable scoring system to predict mortality based on hospital admission data. Methods: Total 227 patients operated for perforated peptic ulcer in two centers were included. All data that may be potential predictors with respect to hospital mortality were retrospectively analyzed. Results: The mortality and morbidity rates were 10.1% and 24.2%, respectively. Multivariated analysis pointed out three parameters corresponding 1 point for each which were age >65 years, albumin <= 1,5 g/dl and BUN >45 mg/dl. Its prediction rate was high with 0,931 (95% CI, 0,890 to 0,961) value of AUC. The hospital mortality rates for none, one, two and three positive results were zero, 7.1%, 34.4% and 88.9%, respectively. Conclusion: Because the new system consists only age and routinely measured two simple laboratory tests (albumin and BUN), its application is easy and prediction power is satisfactory. Verification of this new scoring system is required by large scale multicenter studies.
  • Küçük Resim
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    The predictive value of preoperative neutrophil-lymphocyte and platelet-lymphocyte ratio on overall survival in patients with operable gastric cancer
    (2020) Ozden, Sabri; Gundogdu, Salih Burak; Er, Sadettin; Birben, Birkan; Yildiz, Baris Dogu; Tez, Mesut
    Aim: Elevated preoperative neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) predict overall survival rates among patients with several types of cancer. The current study was conducted to clarify whether NLR and PLR are clinically useful in predicting overall survival among patients undergoing curative resections for gastric cancer. Material and Methods: 202 gastric cancer patients were reviewed retrospectively who had been appealed to our clinic between 2006 and 2013. 192 patients who had local disease, and underwent curative surgery for gastric cancer were included to the study. Data regarding potential prognostic factors including age, sex, preoperative neutrophil, lymphocyte, and platelet counts, postoperative tumor characteristic such as tumor location, tumor size, lymph node metastasis, tumor–nodes–metastasis staging, Lauren's classification of subtypes and survival times were obtained from medical records.Results: No significant correlations were noted between NLR, PLR and tumor location, size, Lauren's classification of subtypes, histology, stage, and type of gastrectomy. Univariate analysis revealed that metastasis at the follow up, sex, T, N stage, and lymph node ratio (LNR) were predictors of worse overall survival. In multivariate analysis, metastasis at follow up (p=0.014; HR:1.81; CI:1,126-2,911) and LNR (p=0.001; HR:3,564; CI:2,175-5,842) were found to be independent variables with worse overall survival. Conclusion: Preoperative NLR and PLR cannot be used as independent variables for prediction of overall survival in patients with operable gastric cancer.