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    Compliance With the Surviving Sepsis Campaign Bundle: A Multicenter Study From Turkey
    (Springernature, 2021) Bahar, Ilhan; Oksuz, Hafize; Senoglu, Nimet; Demirkiran, Hilmi; Aydogan, Mustafa; Tomak, Yakup; Comez, Mehmet
    Objectives Sepsis bundle compliance is not clear. We evaluated rates of compliance with sepsis bundle protocols among health care providers in Turkey. Methods Our study was carried out retrospectively. Forty-five intensive care units (ICU) participated in this study between March 2, 2018 and October 1, 2018. Results One hundred thirty-eight ICUs were contacted and 45 ICUs agreed to participate. The time taken for the diagnosis of sepsis was less than six hours in 384 (59.8%) patients, while if was more than six hours in 258 (40.2%) patients. The median linterquartile range (1QR)1 times for initial antibiotic administration, culturing, vasopressor initiation, and second lactate measurement were 120.0 (60-300) minutes, 24 (12-240) minutes, 40 (20-60) minutes, and 24 (18-24) hours, respectively. The rale of compliance with tissue and organ perfusion follow-up in the first six hours was 0%. The rates of three- and six-hour sepsis bundle protocol compliance were both 0%. The ICU mortality rates for sepsis and septic shock were 22% and 78%, respectively. The ICU mortality rates for sepsis and septic shock were 22% and 78%, respectively. Conclusions The rate of compliance with sepsis bundle protocols was evaluated in Turkey for the first time and determined to be 0%.
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    Prevalence and clinical features of chronic critical illness in the elderly population in Turkey
    (Geriatrics Society, 2020) Demirkiran, Hilmi; Uzunoglu, Emine; Erdivanli, Başar; Karadamar, Ulaş; Koç, Suna; Tomak, Yakup; Özmen, Mustafa
    Objectives: The definition of chronic critical illness in the elderly has not yet been determined. The aim of the study is to determine the prevalence and clinical features of chronic critical illness in the elderly population in Turkey. Materials and Methods: Data from 16 intensive care units of public and private hospitals in Turkey were evaluated. Patients staying in the intensive care units for at least eight days between 2015 and 2017 and having at least one of the additional criteria were accepted as chronic critical illness and they were divided into two groups by age, those 65 and older and those under 65. Results: The chronic critical illness patient rate in the intensive care units was 10.7%. Of chronic critical illness patients in the intensive care units, 60.9% were 65 years of age and older, and the mortality rate of patients 65 years and older was 70%. The frequencies of ischemic stroke and sepsis, the number of patients with comorbidities, and the mortality rate were higher in patients over 65 years of age, while the frequency of traumatic brain injury, presence of a major wound, tracheostomy, length of hospital stay and cost of care were higher in patients under 65 years of age. Conclusion: We determined that prolonged mechanical ventilation, traumatic brain injury, tracheostomy and major wound presence in intensive care units patients 65 years and older increased hospital stay and costs. More work is needed to define chronic critical illness more clearly in elderly. © 2020, Geriatrics Society. All rights reserved.
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    PREVALENCE AND CLINICAL FEATURES OF CHRONIC CRITICAL ILLNESS IN THE ELDERLY POPULATION IN TURKEY
    (Gunes Kitabevi Ltd Sti, 2020) Demirkiran, Hilmi; Uzunoglu, Emine; Erdivanli, Basar; Karadamar, Ulas; KOc, Suna; Tomak, Yakup; Ozmen, Mustafa
    Objectives: The definition of chronic critical illness in the elderly has not yet been determined. The aim of the study is to determine the prevalence and clinical features of chronic critical illness in the elderly population in Turkey. Materials and Methods: Data from 16 intensive care units of public and private hospitals in Turkey were evaluated. Patients staying in the intensive care units for at least eight days between 2015 and 2017 and having at least one of the additional criteria were accepted as chronic critical illness and they were divided into two groups by age, those 65 and older and those under 65. Results: The chronic critical illness patient rate in the intensive care units was 10.7%. Of chronic critical illness patients in the intensive care units, 60.9% were 65 years of age and older, and the mortality rate of patients 65 years and older was 70%. The frequencies of ischemic stroke and sepsis, the number of patients with comorbidities, and the mortality rate were higher in patients over 65 years of age, while the frequency of traumatic brain injury, presence of a major wound, tracheostomy, length of hospital stay and cost of care were higher in patients under 65 years of age. Conclusion: We determined that prolonged mechanical ventilation, traumatic brain injury, tracheostomy and major wound presence in intensive care units patients 65 years and older increased hospital stay and costs. More work is needed to define chronic critical illness more clearly in elderly.