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Adaptation of Diabetic Empowerment Scale-Short Form to Older Individuals and to Turkish Language: Validity and Reliability Study
(Aves, 2020) Jahanpeyma, Parinaz; Karaman, Emine; Yildirim, Yasemin; Sahin, Sevnaz; Aykar, Fisun Senuzun
Objective: the empowerment of old people is important in order for them to gain control over their own lives and to raise their quality of life. the purpose of this study was to adapt the Diabetes Empowerment Scale-Short Form (DES-SF) to old people and to the Turkish language, and to determine its validity and reliability. Materials and Methods: This methodological type study was conducted between 1 January and 30 March 2017 with 106 old people fitting the criteria of acceptance in the study who attended the geriatrics clinic of a university hospital. in determining validity, language equivalence, content, and predictive validity were used, while reliability was tested with temporal invariance, Cronbach's alpha coefficient, and item total correlation. We examined its reliability and validity via item analyses, content validity (expert panel), confirmatory factor analyses, and construct validity (exploratory factor analyses). Results: the Cronbach's alpha of the scale was 0.883. the scale items were grouped under a single factor in accordance with the original. Confirmatory and exploratory factor analysis showed good fit signs. Conclusion: After conducting validity and reliability testing on the adaptation of the Diabetic Empowerment Scale-Short Form to old people and the Turkish language, it is was concluded that it is a reliable scale to determine the empowerment levels of old people. Based on the statistical analyses applied to evaluate the validity and reliability of the scale obtained by adapting the DES-SF to old people, it was inferred that it is an instrument with high validity and reliability. the scale is a short and practical instrument to evaluate the empowerment levels of old people. the new name of the scale is the elderly empowerment scale.
Antimicrobial Resistance Rates and Risk Factors for Extended-Spectrum Beta-Lactamase-Producing Escherichia coli-Associated Urinary Tract Infections in Older Outpatients in East Anatolia from 2011-2019
(Briefland, 2023) Sahin, Sevnaz; Karasahin, Omer; Tasar, Pinar Tosun
Background: Community-acquired urinary tract infection is among the most common infections in older adults. Regardless of age, the most frequently detected causative microorganism is Escherichia coli. In parallel with the increase in antibiotic use, the frequency of community-acquired extended-spectrum beta-lactamase-producing E. coli (ESBL-E. coli) has reached critical levels. The use of empirical antibiotic therapy is determined by assessing patient-based risk factors. Therefore, knowing the risk factors and the frequency of antimicrobial resistance can guide the treatment to shape the treatment.Objectives: This study aimed to determine the risks and resistance frequencies to guide the empirical treatment selection for ESBL-E. coli-associated urinary tract infection (UTI) in elderly patients.Methods: This study is a retrospective cohort study. It was carried out between 2011-2019. Escherichia coli growth of >= 105 colony -forming units (cfu)/mL in urine culture was included in 815 patients aged 65 and over who applied to outpatient clinics.Results: Two hundred and sixty (31.9%) of the patients had ESBL-E. coli. In ESBL-E. coli, antimicrobial resistance rates were highest (100%) for penicillins + beta-lactamase inhibitors. The lowest resistance rates were determined for carbapenems, aminoglycosides, phosphonic acid, and nitrofurantoins. Risk factors for ESBL-producing bacteria were determined. These were the presence of benign prostatic hypertrophy, antibiotic use in the last three months, history of UTI in the last year, urinary catheter uses in the last year, male gender, and hospitalization in the last year (P < 0.05). The only independent risk factor was a history of UTI in the last year, which increased the risk of ESBL by 2.8 times.Conclusions: Carbapenems can be chosen as parenteral options, and phosphonic acids and nitrofurantoin as oral options for em-pirical antibiotic treatment, especially in patients with a history of UTI in the past year.
Association of sarcopenia with depressive symptoms and functional status among ambulatory community-dwelling elderly
(Elsevier Ireland Ltd, 2018) Kilavuz, Asli; Meseri, Reci; Savas, Sumru; Simsek, Hatice; Sahin, Sevnaz; Bicakli, Derya Hopanci; Sarac, Fulden; Uyar, Mehmet; Akcicek, Fehmi
Objective: Sarcopenia, functional disability, and depression are common problems in the elderly. Sarcopenia is associated with physical disability, functional impairment, depression, cardiometabolic diseases, and even mortality. This study aims to determine the association of sarcopenia with depression and functional status among ambulatory community-dwelling elderly aged 65 years and older. Materials and method: The sample of this cross-sectional study consisted of 28,323 people, aged 65 years and older, living in Bornova, Izmir. Multi-stage sample selection was performed to reach 1007 individuals. However, 966 elderly people could be reached, and 861 elderly people who can walk were included in the study. The data were collected by the interviewers at home through face-to-face interview. Results: The mean age was 72.2 +/- 5.8 (65-100) years. The prevalence of functional disability, depressive symptoms, and sarcopenia were 21.7%, 25.2%, and 4.6%, respectively. In multivariate analysis depression was associated with sarcopenia, being illiterate and divorced, perception of the economic situation as poor/moderate, increased number of chronic diseases, and having at least one physical disability. IADL associated functional disability with sarcopenia, being illiterate/literate and female, increased age and number of medications, and the BMI. Conclusion: Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability. Elderly people at high risk of sarcopenia should be screened for functional disability and depression. Appropriate interventions should also be implemented.
THE ATTITUDES OF MEDICAL STUDENTS TOWARD THE ELDERLY
(Gunes Kitabevi Ltd Sti, 2015) Elbi, Huseyin; Altan, Selim; Rahman, Suheyla; Cengiz Ozyurt, Beyhan; Sahin, Sevnaz; Cam, Fethi Sirri
Introduction: Health workers must be prepared for the changes and developments due to the ever-increasing proportion of elderly individuals within the general population. This study aimed to identify the general attitudes of students of the Faculty of Medicine of Celal Bayar University (CBU) toward senility and evaluate differences in the attitudes of students at different stages of medical education. Materials and Method: This study was conducted between October and December 2014 and included a total of 406 students attending the Faculty of Medicine of the CBU. A questionnaire form composed of three sections was used to collect data. Results: The age range of study participants was 18-27 years (average age, 21.04 years), 60.8% were females, and 91.4% had a nuclear family structure. When assessing overall UCLA scores according to the stage of medical education, the average scores of first-year students were found to be higher than other year groups. The results of the UCLA questionnaire demonstrated significantly higher overall scores concerning attitudes toward older persons in female students compared with male students. No significant differences in KOGAN questionnaire scores concerning attitudes toward older people were observed between male and female students. Conclusion: The findings of the present study indicate that attitudes toward the elderly change negatively as students progress through medical education. In addition, female students had more positive attitudes toward elderly patients than male students. Considering the expectations from the healthcare providers of the elderly population, who are more fragile compared to normal individuals, it should be envisaged that the responsibilities of physicians have increased.
Autopsies in the elderly: Erzurum study
(Elsevier Sci Ltd, 2017) Timur, Ozge; Tasar, Pinar Tosun; Ulusoy, Merve Gulsah; Irez, Azem; Yildirim, Filiz; Binici, Dogan Nasir; Sahin, Sevnaz; Kok, Ahmet Nezih
Introduction: Clinical and forensic autopsies are the best methods for determining cause of death. The aim of this study was to determine demographic and etiologic characteristics in geriatric forensic cases analyzed in Erzurum, Turkey. Materials and methods: Autopsy reports and prosecution documents of decedents aged 65 and older autopsied in the Morgue Specialization Department of the Forensic Medicine Institute, Erzurum Division between January 1, 2010 and December 31, 2015 were screened retrospectively. Results: The study included 399 subjects with a mean age of 74.38 +/- 7.28 years. A large proportion of the subjects were in the young and middle old age group (n = 218, 54.63%) and male (n = 286, 71.68%). Autopsy was performed on 198 (49.62%) of the subjects, cause of death was determined by post-mortem external examination in 199 (49.87%), and documents were unavailable for 2 subjects. Cause of death was determined as natural in 130 (32.58%) of the decedents and unnatural in 269 (67.42%). The most common natural cause of death was cardiovascular disease (n = 94, 76.4%). Unnatural causes of death included accident in 223 (82.90%), suicide in 25 (9.30%) and homicide in 21 (7.80%) of the decedents. A large proportion of the accidents were traffic accidents (n = 120, 53.80%). The most common method of committing suicide was hanging (n = 15, 60%), whereas homicides were most often committed by blunt force trauma (n = 9, 42.86%). Conclusion: Our data are consistent with the literature, allowing for some variation based on regional sociocultural characteristics. (C) 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
The characteristics of older people suicides by sex and age subgroups
(Elsevier Ireland Ltd, 2020) Kaya, Ahsen; Tasar, Pinar Tosun; Meral, Orhan; Sahin, Sevnaz; Balkay, Mustafa; Aktas, Ekin Ozgur; Akcicek, Fehmi
As the older population steadily grows, a corresponding increase in elderly suicides is also expected. In addition, due to differences in the physical and psychosocial characteristics of this age group, the characteristics of elderly suicides are predicted to be different to those of other groups. In this study, we aimed to report the characteristics of suicides 60 years and older according to sex and age subgroups. We retrospectively reviewed the autopsy reports of individuals aged 60 and older who committed suicide in Turkey during the 10-year period between 2005 and 2014. Their age, sex, cause of death, and year, month, season, place, and method of suicide were analyzed. Comparisons were made based on sex, age subgroup, demographic variables, and descriptive characteristics of the suicides. Of 17,942 forensic autopsies, 525 were elderly suicides. Of these, 77.3% were men and the mean age was 71.26 +/- 8.16 (range, 60-94) years. There were statistically significant differences in suicide method according to sex (p < 0.001, X = 43.984) and age subgroups (p = 0.001, X = 51.457). For both sexes, hanging was the most common suicide method (59.4%) and the majority of suicides occurred at home (73.1%). The suicides occurred more frequently in the 65-74 age subgroup, in the summer, and in the months of June and July. Identifying the characteristics of elderly suicides, especially by sex and age subgroups, may be beneficial for suicide risk assessment and the development of prediction and prevention programs.
Comparison of the C14 urea breath test and histopathology in the diagnosis of helicobacter pylori in the elderly
(Pakistan Medical Assoc, 2012) Atli, Teslime; Sahin, Sevnaz; Arslan, Bilge Ugur; Varli, Murat; Yalcin, Ahmet Emre; Aras, Sevgi
Objectives: To compare the sensitivity and specificity of C[14] urea breath test with histopathological findings in biopsies obtained through endoscopy. Methods: In this cross-sectional study, conducted at the Medical Faculty Ankara University, Ankara, Turkey between January and October 2009, 100 patients aged 65 and above who fulfilled the criteria for inclusion were enrolled. Oesophago-gastroduodenoscopy was carried out on the patients after eight hours of fasting, using a Fujinon endoscope, by the same expert. C-14 urea breath tests were carried out on all patients with a capsule containing 37 kBq(1 mu Ci) C-14 urea/citric acid. Evaluation of all data was carried out using SPSS 11.5. Categorical variables were compared through Pearson Chi squared or Fisher's exact test. P<0.005 was taken as statistically significant. Results: The average age of the patients was 71 +/- 5 years; 43 (43%) were male; and 57 (57%) were female. Helicobacter pylon positivity was found to be 35 (35%) in histopathological evaluation, and 36 (36%) in the C-14 urea breath test. Of the 35 patients, 32 (91.4%) were found to be positive by the C-14 urea breath test also. Of the 65 patients who were found to be negative on histopathology, 61(93.8%) were also found to be Hp negative by the C-14 urea breath test, and 4 (6.2%) were evaluated as false positive. A statistically significant correlation (p<0.001) was found between histopathological and C-14 urea breath test results. Compared with histopathology, the sensitivity of the urea breath test was 91.4%, and its specificity was 93.8%. A statistically significant (p <0.001) relationship was found between histopathological results and the results of the C-14 urea breath test. Conclusion: The sensitivity and specificity of the C[14] urea breath test in the group of elderly patients selected was high. The C-14 urea breath test can be considered in the elderly group for diagnosis of Helicobacter pylori infection.
Cross-cultural adaptation, reliability and validity of the Turkish version of the modified Gait Efficacy Scale in community-dwelling older adults
(Taylor & Francis Inc, 2022) Ozden, Fatih; Ozkeskin, Mehmet; Sahin, Sevnaz
Background There are no published studies on the cross-cultural adaptation of the modified Gait Efficacy Scale (mGES) to Turkish and investigated its reliability and validity. Purpose The aim of the study was to cross-culturally adapt the mGES to Turkish (T-mGES) and to prove its psychometric properties in community-dwelling older adults. Methods International translation strategies and cultural adaptation procedures were used. A total of 103 community-dwelling older adults (73 women, 30 men) have participated in psychometric property analysis. Participants were assessed using the T-mGES, Activity Specific Balance Confidence Scale (ABC) and the Falls Efficacy Scale-International (FES-I). T-mGES was recompleted one week later. Results The mean age of the individuals was 67.8 +/- 4.8 years. The T-mGES had strong test-retest reliability (ICC: 0.835, CI 95%: 0.72-0.90). The T-mGES' overall score had strong internal consistency (Cronbach's alpha: 0.961). The SEM95 and MDC95 values for the total score were 6.62 and 18.34, respectively. T-mGES had a strong relationship with ABC and FES-I (r(1): 0.899, r(2): -0.707, p < .01), indicating a high (r > 0.50) construct validity. On the other hand, factor analysis results proved a one-dimensioned structure of the T-mGES. Conclusion T-mGES is a reliable and valid questionnaire for assessing gait efficacy in Turkish speaking community-dwelling older adults. T-mGES provides a straightforward measure due to its unidimensional form.
Delirium is associated with increased mortality in the geriatric population
(Taylor & Francis Ltd, 2018) Tasar, Pinar Tosun; Sahin, Sevnaz; Akcam, Nur Ozge; Dinckal, Cigdem; Ulusoy, Merve Gulsah; Sarikaya, Ozan Fatih; Duman, Soner; Akcicek, Fehmi; Noyan, Aysin
Objective: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients.Methods: The medical records of 1435 patients over 65years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates.Results: The prevalence of delirium was 25.5%. The delirium group was older (p<.0001) and had a larger proportion of males (p<.0001). Mortality rate was higher in the delirium group at 1, 2, 3, 4, and 5years (p<.0001 for all). Age, gender, lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease emerged as significant parameters associated with mortality. Multivariate analysis of these parameters indicated that comorbid diseases (lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease) are risk factors for mortality independent of demographic data such as age and gender.Conclusions: Independent of all other factors, delirium is associated with higher mortality risk.
Effects of the Otago exercise program on falls, balance, and physical performance in older nursing home residents with high fall risk: a randomized controlled trial
(Springer, 2021) Jahanpeyma, Parinaz; Kayhan Kocak, Fatma Ozge; Yildirim, Yasemin; Sahin, Sevnaz; Senuzun Aykar, Fisun
Purpose The aim of this study was to evaluate the effects of Otago exercises on falls, balance, and physical performance in old-aged adults with high fall risk living in a nursing home. Methods This randomized controlled trial included 72 individuals over 65 years of age residing in a single nursing home in Izmir, Turkey. The participants were randomized into the Otago exercise group and walking (control) group. The Otago group performed 45 min of Otago exercises 3 days/week for 12 weeks plus a walking program on 3 other days of the week. The control group did only the walking program (minimum of 30 min 3 days/week). Number of falls, Berg Balance Scale (BBS), 30-s Chair Stand Test (30 s-CST), and 6-min Walk Test (6MWT) were assessed before the intervention and at the end of the 3-month intervention. The primary outcome was number of falls. Results The groups were well matched in terms of age (74.6 +/- 5.9 vs. 75.8 +/- 4.5) and sex (p > 0.05). The Otago group showed a significantly greater reduction in number of falls at the end of the intervention (p < 0.05). of the secondary outcomes, the Otago group had greater median increases in BBS score (p < 0.05) and 30 s-CST score (p < 0.05) post-intervention compared to the walking group. There was no significant difference between the groups in terms of post-intervention change in 6MWT distance (p > 0.05). Conclusion The Otago exercise program improved balance and physical performance and reduced falls in our sample and may be effective in falls prevention interventions for old-aged nursing home residents. Key summary pointsAim This study evaluated the effects of Otago exercises on falls, balance, and physical performance in older adults with high falls risk living in a nursing home. Findings The Otago exercise group showed a significantly greater reduction in number of falls at the end of the 3-month intervention compared to the walking group. Message The Otago exercise program may have a role in the prevention of falls in older persons.
THE EFFECTS OF THIAZIDE AND THIAZIDE-LIKE DIURETICS ON THE RELATIONSHIP BETWEEN NORMAL SERUM URIC ACID LEVELS AND COGNITIVE FUNCTION
(Gunes Kitabevi Ltd Sti, 2021) Kayhan Kocak, Fatma Ozge; Ay, Seval; Ertuna, Elif; Arun, Mehmet Zuhuri; Sahin, Sevnaz; Sarac, Zeliha Fulden; Akcicek, Selahattin Fehmi
Introduction: The objective of this study was to identify the possible effect of thiazide and thiazide-like diuretic use on the relationship between uric acid and cognitive function in geriatric patients with normal renal function. Method: Serum uric acid levels and Mini-Mental State Examination scores of 238 patients (age >= 65 years) treated in an outpatient geriatric clinic were evaluated in this observational, cross-sectional, retrospective study. The effect of thiazide diuretic use on Mini-Mental State Examination score was also assessed. Results: Compared to patients that are not currently taking thiazide diuretics (non-thiazide group) serum uric acid was significantly higher in patients using thiazide and thiazide-like diuretics (thiazide group) (5.27 +/- 0.12 vs 6.09 +/- 0.20; P< 0.001). Although the serum uric acid levels were higher in the thiazide group the Mini-Mental State Examination scores were similar to the non-thiazide group. There was a strong positive correlation between serum uric acid levels and Mini-Mental State Examination score in both groups (P< 0.001). The Mini-Mental State Examination score was significantly lower in the lowest serum uric acid quartile in both groups (P< 0.001). Conclusions: Low serum uric acid levels are associated with cognitive impairment; a slight but significant increase of serum uric acid due to thiazide diuretic use does not seem to enhance cognitive function in geriatric patients.
Evaluation of attempted older adults suicides admitted to a University Hospital Emergency Department: Izmir study
(Elsevier Science Bv, 2017) Gokcelli, Duygu Keskin; Tasar, Pinar Tosun; Akcam, Nur Ozge; Sahin, Sevnaz; Akarca, Funda Karbek; Aktas, Ekin Ozgur; Duman, Soner; Akcicek, Fehmi; Noyan, Aysin
Introduction: Advanced age is one of the risk factors for attempting suicide. Suicide attempts are one of the reasons for elderly patients to admit emergency services. The aim of this study was to investigate the relationship between suicidal behavior and sociodemographic factors and concurrent somatic diseases. Methods: The medical records of patients aged 60 years and over who presented to the emergency department of our university hospital for attempted suicide between the dates of January 1, 2007 and December 31, 2015 were screened retrospectively. Individuals recorded as cases of suicide on the forensic case report form were identified, the data recorded at our hospital were obtained, and telephone interviews were conducted to acquire any missing data. Results: A total of 63 patients with a mean age of 65.88 years were included in the study. A large proportion of the suicide attempts occurred in the years 2014 and 2015. Overall, 23.8% of the patients had a previous history of suicide attempt. Overdose was the method in 74.6% of the suicide attempts, and 70.2% were impulsive; 63.5% of the patients had a history of psychiatric disease. The most common psychopathology was major depressive disorder. Conclusion: We found that suicide attempts were more common among older adults with a history of depression, that approximately one in four had previously attempted suicide, and that the majority of individuals attempting suicide chose to use their own medication.
Evaluation of the quality of life in the university of third age students: a cross-sectional study
(Springer, 2023) Sahin, Sevnaz; Kocakoc, Nurgul; Arayici, Mehmet Emin; Baybas, Bugce Kamer; Boyacioglu, Hayal; Akcicek, Selahattin Fehmi
Aim To investigate the quality of life (QoL) and related factors in university of third age (U3A) students, as well as to compare the QoL between those who participated in education and those who did not. Findings The highest value was found in the psychological and general health sub-parameter, and the lowest value in the social relations sub-parameters. The physical health scores of the former students were higher than those of the new students. Message It was determined that the QoL of the individuals participating in the U3A training was positive in terms of the physical health sub-dimension. In order to determine the effect of the U3A training program, it is recommended to conduct research that can be evaluated before and after the training. Purpose The purpose of this paper was to determine the quality of life (QoL) and related factors in university of third age (U3A) students, as well as to compare the QoL between those who participated in education and those who did not. Methods Two hundred seventy-one people aged 60 and over who are students at Ege U3A, were included in this cross-sectional study. Demographic data of participants were collected through a pre-prepared form. Data on the QoL of individuals were collected through the short form of the WHO QoL Scale (WHOQOL-BREF). Results A total of 271 participants were included in this study. 82.2% (n = 221) of the research group were women. In U3A, 65.3% (n = 177) of the individuals were former students. The highest value was found in the psychological and general health sub-parameter with 75.0%, and the lowest value in the social relations sub-parameters with 66.7%. The scores of sub-parameters of social environment were significantly higher in men than in women (p < 0.001, respectively). The physical health scores of the former students were higher than those of the new students (p < 0.001). Conclusions It was determined that the QoL of U3A students was higher among males, those with higher education levels, and those who were married, as well as that the QoL of the individuals participating in the U3A training was positive in the physical health sub-dimension. There is a need for future studies in which pre- and post-training evaluations will be conducted to determine the impact of the U3A training program.
FACTORS AFFECTING DRUG INTERACTIONS AND THEIR CLINICAL IMPORTANCE IN GERIATRIC OUTPATIENTS
(Gunes Kitabevi Ltd Sti, 2023) Arun, Mehmet Zuhuri; Yildiz, Iffet Zeynep; Taskiran, Emin; Sahin, Sevnaz; Ertuna, Elif
Introduction: Polypharmacy can lead to drug-drug interactions. The aim of this study was to determine the possible factors affecting the prevalence and clinical importance, and interrater reliability of clinical significance of drug interactions in geriatric outpatients. Materials and Method: Potential drug-drug interactions in 228 patients treated in an outpatient geriatric clinic were evaluated in this cross-sectional, retrospective study. The potential significance of the interactions was reviewed separately by a geriatrician and a clinical pharmacist.Results: A total of 1342 drugs were prescribed (median 6 [2-14], per patient). Mean age of the patients was 78 & PLUSMN;0.5 (65-96). Polypharmacy was present in 64.0% of the patients. A weak positive correlation was found between patient age and the number of drugs used (Rs =.205; p=.002). No drug interaction was detected in 18.0% of the patients. In the prescriptions of the remaining 187 patients 760 category C, 70 category D, and 18 category X interactions (Lexicomp & REG;) were detected. A strong positive correlation was found between the number of drugs per patient and the number of drug interactions (Rs =.734; p<.001). There was a strong correlation between the number of interactions and the presence of polypharmacy (rpb=.702, p<.001). The measure of agreement between the clinicians was more pronounced for category D and X interactions (Cohen's K=.714 and 1, p<.001).Conclusion: Advanced age, a higher frequency of concomitant use of drugs, and polypharmacy are factors that require clinicians to be aware of drug-drug interactions. Clinical pharmacists can work with geriatricians in outpatient clinics to prevent drug interactions.
Factors Associated with Mortality in Hospitalized Older Adults
(Galenos Publ House, 2023) Tasar, Pinar Tosun; Sahin, Sevnaz; Karasahin, Omer; Unes, Mevlut; Ozturk, Zehra Kosuva; Aykar, Fisun Senuzun
Aim: This study aimed to evaluate mortality risk associated with readily accessible laboratory parameters and underlying conditions in hospitalized older adults. Materials and Methods: This retrospective study included geriatric patients admitted for inpatient care to the internal medicine wards of two major university hospitals in two different regions of Turkey. Data related to the patients were collected by retrospective review of patient charts and electronic records. Survival data were obtained from the Death Reporting System of the Turkish Ministry of Health. Survival after admission at 30 days and 1 year was noted. Results: The study included 1.465 hospitalized older adults with a median age of 74 years, of whom 51% were women. Of these patients, 115 (7.8%) died within 30 days and 382 (26.1%) died within 12 months. For 30-day mortality, independent risk factors appeared to be infectious diseases [odds ratio (OR) 2.109, p=0.006], receiving palliative support (OR 5.982, p=0.006), malignancy (OR 2.514, p=0.001), Charlson Comorbidity Index (CCI) (OR 1.219 per unit increase, p<0.001), MPV (OR 1.525 per unit increase, p<0.001), and CRP (OR 1.006 per unit increase, p<0.001). For 12-month mortality, independent risk factors were found to be infectious diseases (OR 1.978, p=0.01), palliative support (OR 6.506, p<0.001), malignancy (OR 2.654, p<0.001), CCI (OR 1.200 per unit increase, p<0.001), and CRP (OR 1.006 per unit increase, p<0.001). Conclusion: The results of this study show that CCI, CRP, and NLR were associated with higher mortality both at 30 days and 12 months. A one-unit increase in MPV was an independent risk factor for 30-day mortality and increased the odds of mortality by 52.5%.
Factors Determining Mortality in Geriatric Palliative Care Patients
(Taiwan Soc Geriatric Emergency & Critical Care Medicine-Tsgecm, 2020) Tasar, Pinar Tosun; Karasahin, Omer; Timur, Ozge; Yildirim, Filiz; Sahin, Sevnaz
Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. the aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 +/- 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. of the 153 surviving patients, 94 (61.4%) died within 12 months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level < 3.2 mg/L with 2.12-fold reduction in survival time. in addition, post-discharge 12-month survival time was 1.80-fold shorter in the presence of solid organ malignancy, 2.06-fold shorter with APACHE-II score > 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) > 6.5, and 1.98-fold shorter with albumin levels < 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level. Copyright (C) 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
Features of Pressure Ulcers in Hospitalized Older Adults
(Lippincott Williams & Wilkins, 2014) Aygor, Hulya Eskiizmirli; Sahin, Sevnaz; Sozen, Emine; Baydal, Basak; Aykar, Fisun Senuzun; Akcicek, Fehmi
BACKGROUND: The objectives of this study were to examine the prevalence and risk of pressure ulcers (PrUs) among hospitalized patients 65 years or older in a university hospital setting and to assess the potential for prevention and healing in that population. METHODS: The retrospective study conducted at the general medicine departments of Ege University Hospital in Izmir, Turkey, included 209 patients (115 females, 94 males) 65 years or older, who had been admitted to the hospital for a variety of reasons between April 1, 2011, and October 1, 2011. The following tools were used to collect data: a data collection form to identify the sociodemographic and medical characteristics of the patients, the Braden Risk Assessment Scale to assess the risk of PrUs, and a form to monitor PrUs, which included the site of the PrU, the category, and the PUSH (Pressure Ulcer Scale for Healing) score, a tool for tracking changes in PrUs status applied at weekly intervals. RESULTS: The mean patient age was 73 (6.4) years. The prevalence of PrUs was 5.8% during the hospital stay. Pressure ulcers appeared most frequently in the ischeal tuberosity area (40%), and 45.2% of all PrUs observed were category II. The comorbidities of the patients who had PrUs were as follows: rheumatoid arthritis, 40% (n = 5); acute renal failure, 24% (n = 3); multiple myeloma, 8% (n = 1); chronic renal failure, 8% (n = 1); pneumonia, 8% (n = 1); and acute lymphoblastic leukemia, 8% (n = 1). CONCLUSIONS: Pressure ulcers are a common healthcare complication in the older adult population, with potentially severe consequences. The most important intervention that healthcare professionals can make to reduce PrUs is to determine and address risk factors.
Frequency and Risk Factors of Re-hospitalization in Geriatric Inpatient Wards: A Multicenter Retrospective Analysis
(Taylor & Francis Inc, 2023) Kocak, Fatma Ozge Kayhan; Sahin, Sevnaz; Taskiran, Emin; Simsek, Hatice; Daylan, Ayse; Arman, Pinar; Dikmeer, Ayse
Purpose We aimed to evaluate frequency and risk factors of re-hospitalization which are not stated in comorbidity indexes in geriatric wards. Methods A total of 585 patients who were admitted to tertiary care geriatric inpatient clinics at least once between 1 September 2017 and 1 September 2018 and who survived to discharge during initial hospitalization were included in this cross-sectional retrospective multicenter study. Results Overall, 507(86.7%) patients were hospitalized once for treatment during the study period, while re-hospitalization occurred in 78(13.3%) patients. Rates of previous surgery (10.3 vs. 3.0%, p = .006), urinary incontinence (UI) (50.0 vs. 36.3%, p = .021), controlled hypertension (64.1 vs. 46.4%, p = .024), malnutrition (55.1 vs. 29.6%, p = .014) were significantly higher in re-hospitalized patients. Re-hospitalized patients were younger (mean +/- SD 76.4 +/- 8.3 vs. 79.6 +/- 7.9 years, p = .002) than once-hospitalized patients. Multivariate logistic regression analysis revealed the younger patient age (OR, 0.942, 95% CI 0.910 to 0.976, p = .001), higher Modified Charlson Comorbidity Index (MCCI) score (OR, 1.368, 95% CI 1.170 to 1.600, p < .001) to significantly predict the increased risk of re-hospitalization. Conclusions Our findings showed that previous history of surgery and geriatric syndromes such as UI, malnutrition were determined to significantly predict the increased risk of re-hospitalization. We suggest that these risk factors be added to prognostic tools designed for elderly patients.
Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: A multicenter study
(Elsevier Ireland Ltd, 2015) Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif
Objective: The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. Methods: This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. Results: A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Conclusion: Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
Hepatic portal venous gas and pneumatosis intestinalis
(Cukurova Univ, Fac Medicine, 2017) Yilmaz, Tugba Kiper; Tasar, Pinar Tosun; Timur, Ozge; Binici, Dogan Nasir; Aslan, Adem; Kahraman, Mustafa; Sahin, Sevnaz

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