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Öğe Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR(Feray Akbaş, 20.11.2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Köseoğlu, Mehmet; Uzun, Nedim; Sahın, Anıl; Çelik, ÖmerIntroduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.Öğe Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR(Erkan Mor, 20.11.2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Köseoğlu, Mehmet; Uzun, Nedim; Sahın, Anıl; Çelık, OmerIntroduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.Öğe Relationship between systemic immune-inflammation index and no-reflow in percutaneous coronary intervention for saphenous grafts(Future Medicine Ltd, 2023) Demirci, Gokhan; Sahin, Ahmet A.; Aktemur, Tugba; Demir, Ali R.; Cetin, Ilyas; Karakurt, Huseyin; Arslan, EnesObjective: In this study, we investigated the occurrence of no-reflow (NR) in percutaneous coronary intervention (PCI) for saphenous vein grafts (SVGs) and its relationship with a new systemic immune-inflammation index (SII) that determines inflammation. Methods: We studied 303 patients with acute coronary syndrome without ST elevation who underwent PCI for SVG disease. Results: NR formation during SVG PCI was significantly higher in patients with high SII (p < 0.001). NR occurrence was 12.8% when SII was & LE;548 and 41.9% when SII was >548. Conclusion: Our study is the first to investigate SII as the state of inflammation and its effect on the SVG PCI. Patients with higher SII have a higher risk of NR during an SVG for PCI. Plain language summaryThis study is about a type of surgery called bypass surgery, which is done to help when the heart is not working properly. During this surgery, doctors sometimes use veins in the leg to create new pathways for blood to flow around the heart. However, after a while these vessels can narrow or become blocked, so another procedure, stenting, is done to open them. Even after the stent is placed, the blood flow through the vein is sometimes not as good as it should be. This is called 'no reflow'. We wanted to investigate how often this problem occurs and whether it is related to a marker called the systemic immune-inflammation index (SII), which is a measure of inflammation in the body.We analyzed 303 patients who underwent stenting after a heart attack. We divided them into two groups according to their SII scores and investigated whether there was a difference in no-reflow occurrence between the two groups. We found that patients with a higher SII score were more likely to have no reflow during the stenting procedure, and an increased risk of no reflow if the SII score was above 548.This study was the first to look at SII and how it affects the stenting procedure for vessels used in bypass surgery.Öğe The Relationship of CHADS2 Score with In-stent Restenosis in Patients Undergoing Iliac Artery Stenting(Ali Cangül, 2024) Demirci, Gökhan; Sahın, Anıl; Altunova, Mehmet; Aktemur, Tugba; Tekin, Meltem; Yildiz, Mustafa; Erturk, MehmetAmaç: Aorto-iliyak tıkayıcı hastalığa (AIOD) perkütan müdahale, açık cerrahi yerine onaylanmış bir tedavi seçeneğidir. Ancak stent teknolojisindeki gelişmelere rağmen stent içi restenoz (ISR), özellikle bu hastaların uzun dönem takiplerinde hala potansiyel bir sorun olmaya devam etmektedir. CHADS2 skoru temel olarak atriyal fibrilasyon için bir risk sınıflandırma aracıdır; ancak aterosklerozun şiddeti ve perkütan girişimlerin daha kötü sonuçlarıyla ilişkili olduğu bulunmuştur. Böylece AIOD nedeniyle stent takılan hastalarda CHADS2 skoru ile ISR arasındaki ilişkiyi sorgulamayı amaçladık. Gereç ve Yöntem: Bu çalışma, başarılı ana iliak arter (CIA) ve eksternal iliyak arter (EIA) stent implantasyonu yapılan 419 ardışık hastayı içeren retrospektif, gözlemsel bir çalışmaydı. İşlem sonrası ISR, takip döneminde her hasta için ultrasonografi veya anjiyografi ile değerlendirildi. Daha sonra hastalar ISR (+) ve ISR (–) olmak üzere iki gruba ayrıldı. Her hasta için CHADS2 skoru hesaplandı. Bulgular: 419 hastanın 47'sinde ISR tespit edildi. ISR'si olan hastaların stent çapı daha küçük (8,4±0,9 vs. 7,2±2,8, p=0,005) ve stent uzunluğu daha fazlaydı (80 (59–120) mm vs. 59 (39–100) mm, p<0,001). CHADS2 skoru ISR'si olan hastalarda ISR'si olmayanlara göre anlamlı düzeyde yüksek bulundu (2,04±0,98 vs. 1,45±0,93, p<0,001). KOAH (HR: 2,85, %95 GA: 1,535–5,293, p=0,001), CHADS2 skoru (HR: 1,571, %95 GA: 1,186–2,081, p=0,002) ve stent çapında azalma (HR: 0,582, %95 GA) : 0,366–0,926, p=0,022) bağımsız olarak ISR ile ilişkili olduğu bulundu. Sonuç: Çalışmamız başarılı iliak arter stent implantasyonu yapılan hastalarda KOAH, CHADS2 skoru ve stent çapının ISR ile ilişkili olduğunu gösterdi. Çalışmamıza göre bu basit ve uygulanabilir skorlama sisteminin ISR açısından yüksek riskli hastaları tahmin etmede kullanılabilabilir.
