The Effects of Initial cortisol levels and Vitamin D on Mortality and Hospital Infection Development in Geriatric Patients at Intensive Care Unit

Kutlucan, Leyla; Kutlucan, Ali

doi:10.5505/actamedica.2016.98159

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…Studies have shown that MPV is a marker of inflammation, increases in patients with malignant tumors compared to healthy individuals, and is associated with atherosclerosisrelated cardiovascular diseases (3). It has also been shown that it is associated with mortality and can be used as a prognostic marker when these aspects are considered in critically ill patients (3,11). In our study, mortality was evaluated separately as 30-day and 1-year, and similarly, MPV was found to be associated with increased 30-day and 1-year mortality in intensive care unit patients.…”

Section: Discussionmentioning

confidence: 66%

Relationship of intensive care scoring systems with neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume values

ALTINBAS,

KELES,

YILMAZ

et al. 2024

BLL

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OBJECTIVE: We evaluated the relationship between NLR, PLR, and MPV values and scoring systems frequently used in intensive care units in our study. METHODS: In our retrospective study, patients aged 18 years and over who received treatment in the intensive care unit for at least 48 hours were included. Demographic data, such as age, gender, APACHE II, SOFA and GCS scores, expected mortality, and 30-day and 1-year mortality rates were recorded. RESULTS: There was a significant positive correlation between MPV values and APACHE, SOFA, and expected mortality rates, and a significant negative correlation between GCS values. It was also found to be significant that as the P/L ratio increased, APACHE, SOFA scores, and expected mortality rates decreased and GCS increased. In 30-day and 1-year mortalities, MPV values and CRP/albumin ratios were higher, and calcium values were significantly lower. The N/L ratios were also significantly higher in 1-year mortality. CONCLUSION: In our study, a significant correlation was found between APACHE, GCS, SOFA, expected death rates and MPV and P/L rates. In conclusion, we suggest that in addition to intensive care scoring systems, the N/L ratio, P/L ratio, MPV, and CRP/albumin ratios can be used in the prognosis of patients (Tab. 5, Fig. 2, Ref. 18).

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Section: Discussionmentioning

confidence: 66%

Relationship of intensive care scoring systems with neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume values

ALTINBAS,

KELES,

YILMAZ

et al. 2024

BLL

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“…However on the basis of these data, it is not possible to claim that vitamin D deficiency causes mortality. In large observational studies, vitamin D deficiency had an impact on mortality in the overall population (16)(17)(18)(19)(20). Another restrictive factor is the limited number of cases in our study.…”

Section: Discussionmentioning

confidence: 95%

Serum 25-Hydroxy Vitamin D Levels in Patients with Acute Hepatitis (Ischemic, Toxic, and Viral): Association With Clinical Progression and Mortality

Erguven¹,

Arman²,

Arslan³

et al. 2017

Istanbul Med J

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Vitamin D is a hormone that affects various systems of the body. In addition to the known effect of vitamin D on the musculoskeletal system, recent epidemiologic studies associate low serum vitamin D levels with an increased risk for numerous diseases, including cancers (breast and colorectal cancers), autoimmune diseases (multiple sclerosis and type 1 DM), skin diseases (psoriasis, vitiligo, morphea, hyperkeratotic palmoplantar eczema, and acanthosis nigricans), infectious diseases (tuberculosis, otitis media, upper/lower respiratory tract infections, and influenza infection), type 2 DM, hypertension, cardiovascular diseases, and obesity. This is probably because of the anti-inflammatory and immunomodulatory characteristics of vitamin D, and its possible effects on cytokine levels. Presence of vitamin D receptors in the thymus and peripheral T cells shows vitamin D has important effects on T-cell development and activity. Active vitamin D has a direct effect on T cells and antigen-presenting cells, and it also suppresses the differentiation of B cells to plasma cells and inhibits immunoglobulin production (1, 2).Although numerous studies have investigated the clinical role of vitamin D in chronic infectious diseases, there are few studies that reflect the importance of vitamin D, particularly for the prognosis of inflammatory diseases that acutely affect the liver such as acute toxic, ischemic, or viral hepatitis. It is not known how serum 25-hydroxy (OH) vitamin D levels are affected in acute liver injuries. In addition, it is unknown whether serum vitamin D levels change parallel to the recovery of clinical and biochemical test parameters in patients with acute hepatitis. This study aimed to detect serum vitamin D levels in patients with acute hepatitis and determine whether serum vitamin D levels are associated with acute toxic, ischemic, or viral hepatitis. We also investigated whether serum vitamin D levels contributed to prognosis and/or mortality of patients with acute hepatitis. Objective: Vitamin D is a key regulator of calcium homeostasis and has anti-inflammatory and immunomodulatory effects. Active vitamin D has a direct effect on T cells and antigen-presenting cells. It also suppresses the differentiation of B cells to plasma cells and inhibits immunoglobulin production. Vitamin D supplementation is associated with a favorable outcome in chronic inflammatory diseases. In this study, we aimed to determine serum vitamin D levels in patients with acute toxic, ischemic, or viral hepatitis and whether the levels had an effect on clinical progression or mortality in patients with acute hepatitis. Methods:Forty-eight patients (26 men and 22 women) and 35 controls (16 men and 19 women) aged >18 years who were diagnosed as having acute hepatitis and hospitalized in the Internal Medicine Department were enrolled. To determine serum 25-hydroxy (OH) vitamin D levels, two fasting blood samples, first in the initial 24-48 h following hospitalization and second on the day of discharge, were obtained from the part...

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“…Therefore, the PLR could be considered a systemic inflammatory biomarker. While many diseases may rely on the PLR (i.e., acute kidney injury [ 101 ], hepatocellular carcinoma [ 102 ], myocardial infarction [ 103 ], non-small cell lung cancer [ 104 ], rheumatoid arthritis, and systemic lupus erythematosus), the literature remains unclear whether or not PLR is reliable in predicting sepsis.…”

Section: Discussionmentioning

confidence: 99%

Association of inflammatory biomarkers with overall survival in burn patients: a systematic review and meta-analysis

Nourigheimasi,

Yazdani,

Ghaedi

et al. 2024

BMC Emerg Med

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Introduction The inflammatory response to burn injuries can lead to organ dysfunction that ultimately results in increased mortality and morbidity. This meta-analysis was conducted to determine the efficacy of inflammatory biomarkers, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), procalcitonin (PCT), and C-reactive protein (CRP) as predictive tools of mortality among burn patients. Material and methods The biomarker levels of survivors and non-survivors were consolidated according to guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three main databases were searched electronically: PubMed, Web of Science, and Scopus, on December 8, 2022. The Newcastle–Ottawa Quality Assessment Scale (NOS) was used to evaluate and score the methodological quality of the included studies. The standard mean difference (SMD) with a 95% confidence interval (CI) was utilized. Results Twenty-four studies were included in our systematic review and meta-analysis, (3636 total burn patients), of whom 2878 survived. We found that deceased burn patients had elevated levels of NLR (SMD = 0.60, 95% CI; 0.19–1.00, P < 0.001), CRP (SMD = 0.80, 95% CI; 0.02–1.58, P = 0.04), and PCT (SMD = 0.85, 95% CI; 0.45–1.24, P < 0.001), compared to survivors. However, we found no association between PLR and mortality among burn patients (SMD = 0.00, 95% CI; -0.14–0.15, P < 0.001). In addition, CRP was significantly higher in non-survivors (SMD = 0.80, 95% CI; 0.02–1.58, P =0.04). Similar results were also found about PCT (SMD = 0.85, 95% CI; 0.45–1.24, P < 0.001). When we analyzed the PCT data, collected in the first 24-48 hours, we found similar results; the PCT level was significantly higher in non-survivors in the immediate postinjury-period (SMD = 0.67, 95% CI; 0.31–1.02, P < 0.001). There was no publication bias among studies on the role of NLR in burn (Egger’s test P = 0.91). The based cut-off values for NLR (13), CRP (71), and PCT (1.77) yielded sensitivities of 69.2%, 100%, and 93.33%, and specificities of 76%, 72.22%, and 72.22% respectively. Discussion/Conclusions PCT is a marker of sepsis, therefore its elevated level is presumably associated with a higher incidence and severity of sepsis among non-survivors. In addition, NLR and CRP are promising biomarkers for predicting and guiding prevention against burn deaths in clinical settings.

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The Effects of Initial cortisol levels and Vitamin D on Mortality and Hospital Infection Development in Geriatric Patients at Intensive Care Unit

Cited by 3 publications

References 31 publications

Relationship of intensive care scoring systems with neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume values

Relationship of intensive care scoring systems with neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume values

Serum 25-Hydroxy Vitamin D Levels in Patients with Acute Hepatitis (Ischemic, Toxic, and Viral): Association With Clinical Progression and Mortality

Association of inflammatory biomarkers with overall survival in burn patients: a systematic review and meta-analysis

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