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    Acute-Phase Stroke Outcome and Lipids
    (Kare Publ, 2021) Tokgoz, Osman Serhat; Guney, Figen; Kaya, Ahmet; Bugrul, Ahmet; Eruyar, Esra; Buyukgol, Huseyin; Seyithanoglu, Abdullah
    Objectives: The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS). Methods: This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL- C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days. Results: 64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL- C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors ( TG =100.2 mg/dL, HR:2.413, 95% CI: 1.345-4.327, P:0.004); ( TG/HDL =2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively). Conclusion: Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke.
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    Acute-Phase Stroke Outcome and Lipids
    (Kare Publ, 2021) Tokgoz, Osman Serhat; Guney, Figen; Kaya, Ahmet; Bugrul, Ahmet; Eruyar, Esra; Buyukgol, Huseyin; Seyithanoglu, Abdullah
    Objectives: The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS). Methods: This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL- C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days. Results: 64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL- C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors ( TG =100.2 mg/dL, HR:2.413, 95% CI: 1.345-4.327, P:0.004); ( TG/HDL =2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively). Conclusion: Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke.
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    The Effect of Blood Glucose Value on the Short-term Mortality of Acute Ischemic Stroke
    (Galenos Publ House, 2021) Tokgoz, Osman Serhat; Karakurt, Feridun; Bugrul, Ahmet
    Aim: This study aimed to examine the relationship between short-term mortality and blood glucose values (BGV) obtained during the first week of ischemic stroke, when neurological causes, such as increased intracranial pressure, are mainly predominant in mortality prediction. Materials and Methods: This is a retrospective study that includes 417 patients with acute ischemic stroke (AIS), who were admitted to our hospital within the first 24 hours of the stroke. Data were recorded using the International Classification of Diseases Code. On the first, third, fifth, and seventh days of the stroke, the effect of BGV on the patient's functional outcome was evaluated. Results: Of 417 patients, 90 (21.58%) died within a one-month follow-up period. There was no difference between the mortality and survival groups in terms of diabetes mellitus (DM) history (chi 2=0.783; p=0.224). On the first, third, fifth, and seventh day of the stroke, BGV were significantly higher in the mortality group (130.5 mg/dL, 124.5 mg/dL, 133.5 mg/dL, and 132.5 mg/dL, respectively, according to the receiver operating characteristic analysis) than in the survival group (p<0.05). BGV of the fifth day (133.5 mg/dL) was an independent predictor for mortality (hazard ratio: 3.001; 95% confidence interval (1.43-6.3); p=0.004), while BGV of the other days were dependent on a coma scale. Conclusion: Hyperglycemia predicting short-term AIS mortality might be a DM-independent stress hyperglycemia. Although hyperglycemia is predominantly a coma-scale-dependent [modified Rankin Scale (mRS)] predictor during the first week of blood glucose monitoring, BGV of the fifth day may be an independent predictor of short-term mortality.
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    Electroencephalographic Findings in Patients with COVID-19: A Single-center Experience
    (Galenos Publ House, 2021) Turkmen, Nur; Bugrul, Ahmet; Genc, Bulent Oguz
    Objective: Neurological manifestations associated with coronavirus disease-2019 (COVID-19) are broad and heterogeneous. Although the predominant clinical presentation is respiratory dysfunction, concerns have been raised about the neurological hallmarks. Many reports suggest some findings on electroencephalography (EEG) can be relevant to COVID-19. Materials and Methods: Patients with COVID-19 admitted to hospital and referred for EEG from March 1, 2020 to February 15, 2021, were retrospectively enrolled. When research databases were queried with the terms COVID-19 (ICD code:10: U07.3) and EEG, total number of patients obtained was 32. Number of patients excluded due to unconfirmed diagnose with COVID-19 was 12. Twenty adult patients with certain diagnose of COVID-19 who underwent 21-electrode routine EEG during the outbreak with neurological deterioration were identified. Results: Background abnormalities was evident in one of fourth patients (n=5, 25%). Mild diffuse slowing (n=3, 15%) and focal slowing (n=3, 15%) with left frontotemporal tendency (n=2, 10%) were observed. Epileptiform abnormalities and seizures were detected showing focal (n=4, 20%) or generalized onset (n=1, 5%). Conclusion: Here we performed a retrospective single-centre study to evaluate the electroencephalographic findings in patients diagnosed with COVID-19 since it remains unknown. it needs to be more clarified with increasing number of recordings
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    Prediction of Bleeding by the PRECISE-DAPT Score in Patients with Carotid Artery Stenting
    (Springer, 2023) Ramazanoglu, Leyla; Kalyoncu Aslan, Isil; Bugrul, Ahmet; Onal, Yilmaz; Velioglu, Murat; Topcuoglu, Osman Melih; Gozke, Eren
    PurposeThe predicting bleeding complications in patients undergoing stent implantation and the subsequent dual antiplatelet therapy (PRECISE-DAPT) score predicts the risk of bleeding in patients with dual antiplatelet therapy (DAPT) after percutaneous coronary interventions (PCIs). Patients with carotid artery stenting (CAS) are also treated with DAPT. In this study, we aimed to investigate the performance of the PRECISE-DAPT score in predicting bleeding in patients with CAS.MethodsPatients who had CAS between January 2018 and December 2020 were retrospectively enrolled. The PRECISE-DAPT score was calculated for each patient. The patients were divided into two groups based on their PRECISE-DAPT score: low < 25 and high >= 25. Bleeding and ischemia complications and laboratory data among the two groups were compared.ResultsA total of 120 patients with a mean age of 67.3 +/- 9.7 years were included. Forty-three patients had high PRECISE-DAPT scores, and 77 patients had low PRECISE-DAPT scores. Six patients developed bleeding events during the six-month follow-up, and five of them were in the PRECISE DAPT score >= 25 group. The difference between the two groups regarding bleeding events at six months was significant (P = 0.022).ConclusionThe PRECISE-DAPT score might be used for predicting the bleeding risk in patients with CAS, and the bleeding rate was significantly higher in patients with a PRECISE-DAPT score >= 25.