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BackgroundIn this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country.MethodsModified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant.ResultsThe number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572).ConclusionIn terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts Disclosures All authors: No reported disclosures.

Non-Hodgkin lenfomaların %5-10'unu oluşturan nazal tip NK/T hücreli lenfoma, primer rinonazal lenfomaların içinde düşük sağkalım oranları ve kötü prognozu nedeniyle önem kazanmaktadır. Bu non-Hodgkin lenfoma tipi burun, sinüsler, sert ve yumuşak damağı destrükte ederek, progresif bir klinik tablo ile seyreder. Neden olduğu semptomlar ile invaziv fungal rinosinüzitlerle karışabildiği gibi, altta yatan nazal tip NK/T hücreli lenfomanın hastalarda lokal olarak yarattığı epiteldeki hasar, kan damarlarının invazyonu da sekonder olarak gelişebilecek invaziv fungal rinosinüzitler için risk oluşturmaktadır. Bu yazıda invaziv fungal rinosinüzit şüphesiyle ampirik olarak antifungal tedavi başlanan ve doku kültüründe Aspergillus flavus üremesi olup, patolojiye gönderilen örneklerde nazal tip ekstranodal NK/T hücreli lenfoma tanısı alan bir olgu sunulmuştur. Bu olgu altta yatan immünsüpresif durum, kontrolsüz diabetes mellitus gibi risk faktörleri olmayan hastalarda invaziv fungal sinüzitler ile primer rinonazal lenfoma ayırıcı tanısı yapılmasının önemini vurgulamak amacıyla sunulmuştur.

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