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    Immunization status in chronic obstructive pulmonary disease: A multicenter study from Turkey
    (Wolters Kluwer Medknow Publications, 2019) Özlü, Tevfik; Bülbül, Yılmaz; Aydın, Derya; Tatar, Dursun; Kuyucu, Tülin; Erboy, Fatma; Nizam, M.; Altıntaş, Nejat
    OBJECTIVE: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey. METHODS: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey. RESULTS: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 +/- 2.85 and 0.92 +/- 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation. CONCLUSIONS: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.
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    Microorganisms isolated in COPD patients hospitalised for acute exacerbations and their clinical correlations
    (European Respiratory Soc Journals Ltd, 2012) Örnek, Tacettin; Erboy, Fatma; Atalay, Figen; Altın, Remzi; Tor, Meltem
    [No Abstract Available]
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    Prognostic Value of Renal Dysfunction Indicators in Normotensive Patients With Acute Pulmonary Embolism
    (Sage Publications Inc, 2017) Altinsoy, Buelent; Öz, İbrahim İlker; Örnek, Tacettin; Erboy, Fatma; Tanriverdi, Hakan; Uygur, Firat; Tor, Müge Meltem; Altıntaş, Nejat
    Introduction: Glomerular filtration rate (GFR) and blood urea nitrogen (BUN) are important prognostic indicators for cardiovascular disease. However, data on the relationship between renal dysfunction (RD) and prognosis in patients with acute pulmonary embolism (APE) are limited. The estimated-GFR (eGFR), based on the Modification of Diet in Renal Disease (MDRD) equation, has been suggested as a possible prognostic marker in patients with APE; however, at present, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is thought to be more accurate than the MDRD equation for the estimation of RD. Objective: We investigated whether eGFR(CKD-EPI) or BUN could predict adverse outcomes (AOs) better than eGFR(MDRD) in normotensive patients with APE. Methods: Ninety-nine normotensive patients with APE (aged 22-96, 56% male) were enrolled in the study retrospectively. Adverse outcomes were defined as the occurrence of any of the following: death, cardiopulmonary resuscitation, use of vasopressors, thrombolysis, or mechanical ventilation. Results: In univariate analyses, age, gender (male), heart rate (>110 bpm), serum creatinine, BUN, cardiac troponin (cTn) positivity, right ventricle-left ventricle ratio, eGFR(MDRD), and eGFR(CKD-EPI) were found to be significantly different between those with and without AOs. Comparing area under the curves for AO, we found statistically significant differences between eGFR(CKD-EPI) and eGFR(MDRD) (P = .01) but not between BUN and eGFR(CKD-EPI) or BUN and eGFR(MDRD). Furthermore, 30-day mortality was 36% versus 11% in cTn-positive patients with an eGFR(CKD-EPI) < and 60 mL/min, respectively. Conclusion: There is a close relationship between RD and APE prognosis. We conclude eGFR(CKD-EPI) is a potential prognostic marker for risk stratification in normotensive patients with APE.