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    Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units
    (Galenos Publ House, 2021) Gundogan, Kursat; Akbudak, Ismail Hakki; Hanci, Pervin; Halacli, Burcin; Temel, Sahin; Gullu, Zuhal; Inci, Kamil
    Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P<.001), lactate level >2 mmol/L (2.78 [1.93-4.01], P<.001), age >= 60 years (2.45 [1.48-4.06)], P<.001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P=.003), vasopressor treatment (1.94 [1.32-2.84], P=.001), positive fluid balance of >= 600 mL/day (1.68 [1.21-2.34], P=.002), PaO2/FiO(2) ratio of <= 150 mmHg (1.66 [1.18-2.32], P=.003), and ECOG score >= 1 (1.42 [1.00-2.02], P=.050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.
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    Evaluation of Family Satisfaction Level at Erciyes University Medical Faculty Intensive Care Units with a Validated Survey
    (Erciyes Univ Sch Medicine, 2020) Turhan, Zeynep Yuksel; Akin, Aynur Karayol; Onuk, Sevda; Gundogan, Kursat
    Objective: This study aims to investigate the validity and reliability of the FS-ICU 24 survey in the Turkish language, to evaluate the satisfaction of ICU patients' relatives, and to determine the factors affecting satisfaction. Materials and Methods: In this study, the Turkish version was prepared based on the FS-ICU 24 survey applied to the relatives of ICU patients (Anesthesiology, Internal Medicine, General Surgery and Neurosurgery) at the Erciyes University in the Faculty of Medicine between April 2015 and June 2015. The Turkish version was tested and proven to be reliable and valid. Relatives of patients that were hospitalized for at least 48 hours, who had visited the patient at least once, were included. In this study, 369 surveys were completed. Results: FS-ICU 24 survey was found reliable and valid in Turkish. Patients' relatives were unsatisfied with physical conditions, waiting room setting and frequency of communication with nurses the most. The relatives were highly satisfied with the skills and competency of ICU doctors/nurses, setting of the ICU, completeness of treatment provided. Among the intensive care unit departments, there were not any statistically significantly different satisfaction results (p>0.05). The satisfaction level was found to decrease with increasing education levels and increasing duration of hospitalization (p<0.05). The satisfaction in the group who knew the diagnosis was higher (p<0.05). Conclusion: Even though the general satisfaction level of the patients' relatives was high, satisfaction level can be increased by improving physical factors, such as the waiting room setting, and by training on the communication skills of all staff that have contact with the patients' relatives on communication skills.