Medical Bulletin of Sisli Etfal Hospital最新文献

{"title":"Pediatric Anaphylaxis in Emergency Care: A Detailed Analysis of Demographic and Laboratory Findings.","authors":"Nilay Caliskan, Recep Okur, Alper Kacar, Deniz Ozceker","doi":"10.14744/SEMB.2025.68740","DOIUrl":"10.14744/SEMB.2025.68740","url":null,"abstract":"<p><strong>Objectives: </strong>Anaphylaxis, which has been increasing in frequency parallel to other allergic diseases in recent years, is a life-threatening, acute systemic reaction. Physicians working in pediatric emergency departments (PED) should recognize the signs and symptoms of anaphylaxis and administer initial treatment. This study aims to evaluate the demographic, clinical, and laboratory findings of patients diagnosed with anaphylaxis in the pediatric emergency unit of a tertiary care facility.</p><p><strong>Methods: </strong>Patients diagnosed with anaphylaxis in our unit at the PED were retrospectively reviewed between 2016 and 2023.</p><p><strong>Results: </strong>A total of 100 patients were diagnosed with anaphylaxis in our pediatric emergency department, including 39 girls and 61 boys. Of these patients, 3% were under 2 years of age, 25% were between 2-6 years, and 72% were over 6 years old. In 83% of the cases, anaphylaxis occurred at home, while 11% occurred during medication administration at a hospital. Triggers were identified in 81% of the patients, whereas 19% were diagnosed with idiopathic anaphylaxis. The most common triggers were medications. Food-related anaphylaxis was the second most common trigger, with cow's milk being the most frequent at 8%. The most commonly affected system was the skin and mucosa in 97% of cases. When examining the relationship between age groups and triggers, food allergies were most frequent in children under 2 years old (p<0.001). The average tryptase level measured during anaphylaxis was 5.27 ug/L (1.43-33.6), with idiopathic cases showing a significantly higher average of 9.15 ug/L (6.29-33.6) (p=0.005).</p><p><strong>Conclusion: </strong>Anaphylaxis is a systemic reaction that can be fatal if not treated quickly and accurately. Adrenaline is the single most effective treatment, and pediatric emergency physicians play a crucial role in this context. Our findings suggest that tryptase levels in pediatric patients are often below the widely accepted cut-off; however, larger studies are needed before reference ranges can be redefined.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 4","pages":"533-539"},"PeriodicalIF":1.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Factors Affecting Transurethral Bladder Tumor Resection Quality: A Single-center Study Including 1014 Procedures.","authors":"Ayberk Iplikci, Burak Tufekci, Meftun Culpan, Asif Yildirim","doi":"10.14744/SEMB.2025.56244","DOIUrl":"10.14744/SEMB.2025.56244","url":null,"abstract":"<p><strong>Objectives: </strong>The quality of transurethral resection of bladder tumor (TURBT) significantly affects disease management. Pathology specimens that do not contain detrusor muscle (DM) may be associated with low clinical staging. The aim of this study was to evaluate the factors affecting the detection of DM in TURBT.</p><p><strong>Methods: </strong>A total of 1014 patients who underwent TURBT between June 2016 and June 2024 and met the inclusion criteria were enrolled in the study. The requirements for good-quality TURBT were complete resection and detection of DM in the pathology specimen. All procedures were performed by a total of 17 residents under the supervision of a specialist doctor.</p><p><strong>Results: </strong>DM was obtained statistically significantly more often in patients with large (≥3 cm), multiple, and solid tumors. In addition, DM was observed more frequently in the pathology specimens of patients with high-grade tumors, variant histology (VH), or accompanying carcinoma in situ (CIS). The effect of surgical experience on obtaining DM was evaluated, and senior residents (4th year and final year) were found to be more successful than junior residents (3rd year) (65.3% vs. 58%, p=0.021). Multivariate analysis revealed that tumor architecture and tumor size were significant factors influencing DM acquisition.</p><p><strong>Conclusion: </strong>Surgical success in the TURBT procedure has not been clearly defined, but it is known to be affected by many factors. In our study, the rate of DM detection was found to be lower in low-risk tumors. Increasing experience during urology residency was associated with higher-quality TURBT outcomes.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 4","pages":"540-546"},"PeriodicalIF":1.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Performance of AI Models vs. Orthopedic Residents in Turkish Specialty Training Development Exams in Orthopedics\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.14744/SEMB.2025.05046","DOIUrl":"10.14744/SEMB.2025.05046","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"440-441"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Plasma Exchange in Pediatric Intensive Care and Brief Overview of the Literature.","authors":"Abdulrahman Ozel, Ulkem Kocoglu Barlas, Servet Yuce, Merve Boyraz, Meltem Erol","doi":"10.14744/SEMB.2025.56750","DOIUrl":"10.14744/SEMB.2025.56750","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the therapeutic plasma exchange (TPE) procedures performed in our pediatric intensive care unit (PICU) and to review the relevant literature.</p><p><strong>Methods: </strong>This retrospective study was conducted between 2020 and 2024. Forty-nine patients who received TPE at any point during their PICU stay were included. The groups were categorized as survivors and non-survivors.</p><p><strong>Results: </strong>Of the 49 cases, 71.4% were male, with a median age of 54 months (range 20-135 months). A total of 274 TPE sessions were performed. The three most common indications for TPE were sepsis, trauma induced multiple organ dysfunction syndrome/disseminated intravascular coagulation, and neurological diseases. The non-survivor group had higher rates of chronic illness (p<0.001), pediatric risk of mortality score III, and pre- and post-procedure vasoactive inotropic scores (p=0.005, p<0.001, and p<0.001, respectively). The use of invasive mechanical ventilation and continuous renal replacement therapy (p=0.005, p<0.001, respectively), as well as TPE in cases with sepsis (p<0.001), were more frequent in non-survivors. The most common complication during the procedures was hypotension (9.9%).</p><p><strong>Conclusion: </strong>Sepsis remains the most frequent indication for TPE in PICUs. Although the most common complication of TPE in our study was hypotension, there were no life-threatening complications, suggesting it is a safe treatment modality.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"366-372"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Co-Infection with HPV 16 Have a Worse Effect on Cervical Pathology than HPV 16 Alone?","authors":"Aysun Alci, Necim Yalcin, Mustafa Gokkaya, Gulsum Ekin Sari, Harun Resit Turkmenoglu, Isin Ureyen, Tayfun Toptas","doi":"10.14744/SEMB.2025.34682","DOIUrl":"10.14744/SEMB.2025.34682","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to evaluate whether the presence of other HPV genotypes in addition to HPV16 infection has a negative effect on pathological outcomes.</p><p><strong>Methods: </strong>This retrospective study was conducted using data from patients followed up at the Gynaecological Oncology Clinic of Antalya Training and Research Hospital between 2017 and 2025. Patients who were HPV16-positive and also carried other genotypes in addition to HPV16 were included in the study. HPV genotyping was performed using the Hybrid Capture 2 and CLART Genomica systems.</p><p><strong>Results: </strong>Of the total 2,700 HPV (Human Papillomavirus) -positive women, 524 were HPV16-positive only, while 358 were positive for HPV16 along with other genotypes. Histopathological results, including CIN 2/3, HSIL, and invasive cancer, did not show significant differences between the two groups (p>0.05). However, abnormal colposcopy findings were statistically more prevalent in the co-infection group (p=0.037). Cigarette smoking was associated with a 1.27-fold increased risk for co-infection (p=0.026).</p><p><strong>Conclusion: </strong>The findings of this study indicate that HPV16 is the primary determinant in the development of high-grade cervical pathology, and the presence of other high-risk HPV types does not significantly worsen histopathological outcomes. The results support the importance of a risk-based approach in cervical cancer screening processes and emphasize the need to prioritise early diagnosis and preventive interventions in HPV16-positive individuals.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"338-344"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental and Cognitive Outcomes in 342 Patients With Different Types of Hyperphenylalaninemia.","authors":"Sibel Oz Yildiz, Halise Neslihan Onenli Mungan, Deniz Kor, Fatma Derya Bulut, Berna Seker Yilmaz, Sebile Kilavuz, Gulsah Seydaoglu","doi":"10.14744/SEMB.2025.09471","DOIUrl":"10.14744/SEMB.2025.09471","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The aim of this study is to evaluate neurodevelopmental and cognitive outcomes in patients diagnosed with different types of hyperphenylalaninemia (HPA), identify the factors influencing these outcomes, and contribute to the debate regarding the thresold for initiating dietary treatment based on plasma phenylalanine (Phe) levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with hyperphenylalaninemia (HPA) who were followed up and had developmental and/or cognitive evaluations at the Division of Pediatric Metabolism and Nutrition, Department of Pediatrics, between 1984 and 2018, were retrospectively assessed. The study included patients with mild (Phe:360-600 μmol/L), moderate (Phe:600-1200 μmol/L), or classic Phenylketonuria (PKU) (Phe ≥1200 μmol/L) treated with diet and/or tetrahydrobiopterin (BH4), along with untreated HPA patients (Phe:240-360 μmol/L). This classification was based on plasma Phe levels measured at the time of diagnosis. Denver Developmental Screening Test (DDST), Stanford-Binet test, and Wechsler Intelligence Scale for Children (WISC-R) adapted for Turkish children were applied for developmental and cognitive evaluation. Intellectual disability or developmental delay (ID/DD) was defined as a full-scale intelligence quotient (IQ) &lt;70 on the Stanford-Binet or WISC-R, or as delay in two or more developmental domains on the DDST, with children meeting any of these criteria classified as having ID/DD. The relationships between ID/DD, age at diagnosis, diagnostic methods, plasma Phe levels, and brain MRI findings were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 342 patients were included in the study, comprising 182 (53.2%) females and 160 (46.8%) males. Of these, 53 (15.5%) had mild PKU, 97 (28.4%) had moderate PKU, 102 (29.8%) had classic PKU, and 90 (26.3%) were diagnosed with HPA. A significant association was found between ID/DD and both the age at diagnosis and diagnostic method in patients treated with diet and/or BH4 (p &lt; 0.001 and p &lt; 0.01, respectively). In patients with ID/DD, the median plasma Phe levels at the first, third, and last years of follow-up were significantly higher compared to patients without ID/DD (p &lt; 0.024). White matter abnormalities observed on brain MRI were significantly associated with PKU severity, the presence of ID/DD, and the median plasma Phe levels in the last year of follow-up (p = 0.01, p &lt; 0.001, and p &lt; 0.001, respectively). Notably, 9 (10%) of untreated HPA patients exhibited ID/DD, despite regular follow-up and the absence of known risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In addition to early diagnosis and treatment, lifelong adherence and regular follow-up are essential for achieving normal neurodevelopmental and cognitive outcomes in individuals with PKU. However, clinical management remains heterogeneous across centers. The presence of developmental delay in 10% of untreated HPA patients underscores the need to urgently re-evaluate current","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"380-386"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Patients with Respiratory Disorders About Environmental Smoke.","authors":"Mufide Arzu Ozkarafakili, Metin Yangin, Aslihan Calim","doi":"10.14744/SEMB.2025.59568","DOIUrl":"10.14744/SEMB.2025.59568","url":null,"abstract":"<p><strong>Objectives: </strong>Environmental smoke exposure is a poorly understood issue and might be a potential source of long-term respiratory exposure to toxic pollutants. Both secondhand and thirdhand smoke (THS) exposure are important matters of public health. We aimed to document the knowledge about smoke exposure of vulnerable groups with respiratory diseases.</p><p><strong>Methods: </strong>A total of 911 currently smoking patients admitted to the outpatient clinics between October 2023 - October 2024 enrolled in our study. Following a medical examination and pulmonary function assessment, individuals were asked to complete the BATHS questionnaire on thirdhand smoking exposure.</p><p><strong>Results: </strong>Of the 911smoker participants who comprised our sample, 322 (35.3%) had COPD, 227 (24.9%) had asthma and 570 (62.5%) experienced moderate to severe secondhand exposure. Patients with COPD had the lowest BATHS total and persistence scores (3.61±0.58 and 3.77±0.69, respectively), while asthmatics had the lowest BATHS health scores (3.41±0.46) (p<0.05). Total and subdimension scores were significantly higher among individuals aged 18-30, university graduates, employed in the workforce, and earning exceeds minimum wage (p <0.05). No gender difference was noted (p>0.05). BATHS total scores had significant negative correlation with secondhand smoke exposure and disease duration (p<0.05) whereas positively correlated with better pulmonary function values, attending a smoking cessation clinic, and living at home with children under sixteen (p<0.05).</p><p><strong>Conclusion: </strong>This study identifies the knowledge gap about the detrimental effects of smoke exposure in patients with respiratory diseases. It underscores the importance of focusing initiatives to reduce both active and passive smoking through educational programs targeting active smokers at risk of lung illnesses.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"410-423"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intralesional Platelet-Rich Plasma Injection in Patients with Recalcitrant Alopecia Areata.","authors":"Mert Aydogan, Nermin Karaosmanoglu, Pinar Ozdemir Cetinkaya","doi":"10.14744/SEMB.2025.63444","DOIUrl":"10.14744/SEMB.2025.63444","url":null,"abstract":"<p><strong>Objectives: </strong>Alopecia areata (AA) is a common, chronic autoimmune disease that causes non-cicatricial hair loss. Its relapsing and remitting nature leads to the search for new, effective treatment options. The study aimed to evaluate the therapeutic efficacy of intralesional platelet-rich plasma (PRP) and intralesional steroid (ILS) injections in patients with AA.</p><p><strong>Methods: </strong>A retrospective chart review was carried out from 2020-2021. A total of 75 patients with AA were included in the study. Thirty-six patients were treated with intralesional PRP, and 39 patients were treated with ILS injections for three sessions. The patients were evaluated with a hair pull test and SALT scores at months 0, 3, and 6.</p><p><strong>Results: </strong>Of 75 patients, the mean age of the PRP group was 34.33±10.61, and the mean age of the ILS group was 33.82±13.31 years. After three PRP or ILS therapy sessions, at 3. and 6. months, SALT 3 and SALT 6 scores were statistically significantly lower in the PRP group than in the ILS group (p=0.038, p<0.001, respectively). When the treatment response was evaluated at the end of the 6th month in the PRP group, there was no response in 2 (5.5%) patients, partial response in 1 (2.7%) patient, good response in 3 (8.4%) patients, and very good response in 30 (83.4%) patients. Only 2 (5.9%) patients had a clinical relapse in a 6-month period. Side effects were seen in 16 (44.4%) patients in the PRP group and 8 (20.5%) patients in the ILS group, and the frequency of side effects in the PRP group was statistically significantly higher than in the ILS group (p=0.026). However, the side effects of both groups were minor, such as itching, pain, burning, ecchymosis, and folliculitis.</p><p><strong>Conclusion: </strong>PRP seems to be an effective and safe treatment option for limited patchy alopecia areata, but its superiority over ILS has not been fully demonstrated, making ILS still the first-line treatment.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"387-394"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Has Changed in the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer? Part 2: Postoperative Initial Treatment.","authors":"Mehmet Uludag, Mehmet Taner Unlu, Isik Cetinoglu, Ozan Caliskan, Nurcihan Aygun","doi":"10.14744/SEMB.2025.30906","DOIUrl":"10.14744/SEMB.2025.30906","url":null,"abstract":"<p><p>American Thyroid Association (ATA) guidelines for the management of thyroid nodules and differentiated thyroid cancer (DTC) were first published in 1996 and subsequently updated in 2006, 2009, and 2015. In 2025, the ATA released a revised version focusing exclusively on DTC and excluding thyroid nodules from its scope. In our previous review, we summarized the updates regarding preoperative evaluation, diagnosis, and surgical management of DTC. In this second part of the series, we aimed to compare the 2015 and 2025 ATA guidelines in terms of initial postoperative management. The main changes are evaluated at the level of recommendations, with a particular emphasis on recurrence risk stratification, postoperative risk-adapted surveillance, adjuvant radioactive iodine (RAI) use, postoperative imaging, and radiation safety. This review provides a comprehensive comparison of the 2015 and 2025 ATA guidelines, outlining the key changes in early postoperative management of DTC and highlighting their potential impact on individualized patient care.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"273-283"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Preoperative CHA2DS2-VASc Score in Predicting Late Saphenous Vein Graft Failure in Non-STEMI Patients with Prior Coronary Artery Bypass Grafting: A Retrospective Study.","authors":"Cemalettin Yilmaz, Ahmet Karaduman, Muhammed Mucahit Tiryaki, Regayip Zehir","doi":"10.14744/SEMB.2025.14377","DOIUrl":"10.14744/SEMB.2025.14377","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the prevalence of saphenous vein graft (SVG) failure following coronary artery bypass graft (CABG) surgery, SVGs continue to be widely used. This study aimed to investigate the value of the CHA2DS2-VASc score, originally developed for predicting thromboembolic events in atrial fibrillation, in predicting SVG failure post-CABG.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 526 patients with a history of CABG who presented with non-ST-elevation myocardial infarction between January 2017 and April 2024. SVG failure was defined as exhibiting stenosis of 70% or greater, or complete occlusion. Preoperative CHA2DS2-VASc scores were calculated for each patient. Multivariable analysis was conducted to identify independent predictors of SVG failure.</p><p><strong>Results: </strong>Among the 526 patients, 242 (46%) experienced SVG failure. Patients with SVG failure exhibited higher CHA2DS2-VASc scores. Multivariable analysis identified the CHA2DS2-VASc score (OR: 2.203, 95% CI: 1.672-2.902, p<0.001), time interval after CABG (OR: 1.167, 95% CI: 1.081-1.259, p<0.001), and number of SVGs (OR: 2.378, 95% CI: 1.745-3.241, p<0.001) as independent predictors of SVG failure. Of those parameters, the CHA2DS2-VASc score demonstrated a higher AUC value (AUC=0.796, AUC=0.724, AUC=0.641, respectively).</p><p><strong>Conclusion: </strong>Pre-operative CHA2DS2-VASc score may be predictive of late SVG failure after CABG.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"304-310"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}