Researcher: Aydın, Alp Giray
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Aydın, Alp Giray
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Publication Metadata only Utility of haps for predicting prognosis in acute pancreatitis(Turkish Assoc Trauma Emergency Surgery, 2018) Sayraç, Ali Vefa; Çete, Yıldıray; Yiğit, Özlem; Sayraç, Neslihan; N/A; Aydın, Alp Giray; Doctor; Koç University Hospital; N/ABACKGROUND: Acute pancreatitis (AP) is a common abdominal disorder, which requires early diagnosis and treatment. Several prognostic scoring systems introduced to clinical practice are not suitable in emergency department (ED) because these require much time and complex parameters. Recently, the harmless acute pancreatitis score (HAPS) has been introduced to identify AP with a nonsevere course. The aim of this study was to determine the utility of HAPS in predicting the severity of AP. METHODS: All patients aged > 16 years who were diagnosed as AP in ED were enrolled in this retrospective study. The study included 144 patients with a mean age of 58.7 +/- 15.4 years, and 69 (47.9%) of them were males and 75 (52.1%) were females. Patient data were collected from hospital database. The utility of HAPS was analyzed and compared using the Ranson's score. RESULTS: HAPS was statistically significant for predicting mild disease (p=0.008) and has demonstrated a specificity of 81%, a positive predictive value (PPV) of 96%, and an odds ratio of 5.57 (1.51-20.50). The predictability of Ranson's scores was not significant. The measure of agreement (kappa) between the two scores was 0.15, indicating a low agreement. CONCLUSION: HAPS is a simple and useful scoring algorithm to predict the non-severe course of AP in ED. HAPS-0 patients did not require early aggressive treatments and advanced radiological screening tools during the early stages of the disease.Publication Metadata only Prognosis of critically ill patients in the ED and value of perfusion index measurement: a cross-sectional study(W B Saunders Co-Elsevier Inc, 2015) Oskay, Alten; Eray, Oktay; Dinc, Selcan Enver; Eken, Cenker; N/A; Aydın, Alp Giray; Doctor; Koç University Hospital; N/AObjective: Critically ill patients have high mortality and admission rates requiring early recognition and a rapid management. In the present study, we evaluated the prognostic parameters in these patients and the value of perfusion index measurement as a novel tool for accomplishing emergency department (ED) triage. Methods: Seven hundred seventy patients admitted to the critical care area of the ED in a month composed the study population. Perfusion index and vital signs (blood pressure, pulse rate, body temperature, pulse oximeter, and respiration rate) of the study patients were recorded to the study form. The communication data, admitting time, comorbidities, capillary refilling time, and blood gas analysis findings if obtained were recorded. Outcome of patients at the end of the ED period such as discharge, admission to the hospital, and death were also recorded. Outcome of patients at 15th and 30th days was identified by telephone call follow-up or from hospital records. Results: Two hundred seventy-eight patients (36.1%) were admitted to the hospital, 454 patients (59%) were discharged, 3 patients (0.4%) died in the ED, 25 patients (3.2%) were transferred to another hospital, and 10 patients (1.3%) refused treatment and left the ED. Sixty patients (7.8%), 39 (5.1%) of whom had died in 15 days' period, were dead at the end of 30-day follow-up period. Respiratory rate and pulse oximetry were significant parameters in hospital admission. Systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, pulse oximetry, lactate levels in blood gas analysis, and ED length of stay were significant variables in 30-day mortality rate. Patients who were admitted to the hospital had higher rates of fever and diabetes. Patients who had died in the 30-day follow-up period had higher rates of diabetes and malignancy. In logistic regression analysis, the predictors of hospital admission were hypotension, fever, and pulse oximetry, whereas the predictors of 30-day mortality were systolic blood pressure, respiratory rate, pulse oximetry, and presence of malignancy. Conclusions: Perfusion index as a novel triage instrument was found to be an insignificant tool in predicting hospital admission and mortality of critically ill patients in the ED. However, diabetes and malignancy were found to be independent factors in determining the prognosis of these patients in addition to vital signs and should be considered by ED physicians either in triage field or inside the ED. (C) 2015 Elsevier Inc. All rights reserved.Publication Metadata only Necrotizing fasciitis as complication of combined use of bevacizumab with chemotherapy(Galenos Yayınevi, 2023) N/A; Emir, Cantürk; Aktaş, Can; Aydın, Alp Giray; Doctor; Faculty Member; Doctor; N/A; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; 24297; N/ANecrotizing fasciitis (NF) is an uncommon, severe, life-threatening soft tissue infection involving the subcutaneous tissue. Immunocompromised and patients with diabetes are at a higher risk of developing NF. One of the pathophysiologic mechanisms of NF is subcutaneous arterie thrombosis and tissue ischemia. Bevacizumab, a agent used in cancer treatment, blocks the activity of the vascular endothelial growth factor receptor. Recently, it is used along with paclitaxel and carboplatin due to an increased survival rate. The frequent use of this combination caused patients to applied to the emergency department (ED) with some side effects. NF is one of the rare side effects of this combination. Here, we present a patient with ovarian cancer who was admitted to the ED with severe leg pain, whose initial examination and tests were normal, and then NF developed within hours and then arrested.