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    A Novel Determinant of Prognosis in Acute Pulmonary Edema: Intermountain Risk Score
    (Kare Publ, 2024) Kilic, Raif; Aktan, Adem; Guzel, Tuncay; Kaya, Ahmet Ferhat; Guzel, Hamdullah; Arslan, Bayram; Isik, Mehmet Ali
    Objective: The Intermountain Risk Score (IMRS), calculated using age, gender, complete blood count (CBC), and simple laboratory analyses, is an easy-to-use and cost-effective tool developed to predict mortality. In our study, we aimed to determine whether the IMRS could predict mortality in patients admitted to the hospital with a diagnosis of acute pulmonary edema. Methods: A total of 371 patients who were admitted with a diagnosis of pulmonary edema, were included in our study. The IMRS of the patients was determined using a calculation tool, and the patients were divided into three groups based on the determined value: low, moderate, and high IMRS. Results: The patients included in our study comprised 208 women and 163 men, with an average age of 68.7 years. There was a statistically significant difference between the patient groups concerning both 1-month and 1-year mortality rates. Additionally, there was a significant difference in IMRS between patients who developed in-hospital, 1-month, and 1-year mortality and those who survived. In the Receiver Operating Characteristic (ROC) analysis, a cutoff value of 15.5 for the IMRS predicted both 1-year and 1-month mortality. In the Kaplan-Meier analysis, the highest mortality risk was observed in the high IMRS group and the lowest mortality risk in the low IMRS group. Conclusion: Our research results show that the IMRS strongly predicts both short-term and long-term mortality in patients hospitalized with a diagnosis of acute pulmonary edema.
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    Prevalence of sarcopenia in heart failure with mildly reduced ejection fraction and its impact on clinical outcomes
    (Taylor & Francis Ltd, 2024) Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Guzel, Hamdullah; Kaya, Ahmet Ferhat; Arslan, Bayram; Demirci, Murat
    Background: Sarcopenia is a progressive age-related skeletal muscle disease associated with adverse outcomes in those with cardiovascular disease. In this study, the prevalence of sarcopenia and its effect on clinical outcomes in heart failure with mildly reduced ejection fraction (HFmrEF) patients were examined. Methods: A total of 722 patients from three centres who applied to the outpatient clinic with the diagnosis of HFmrEF between 01 January 2020 and 01 June 2021 were included in the study retrospectively. Sarcopenia was diagnosed with a screening test using age, grip srength and calf circumference. At least two-year follow-up results were reviewed from the date the patients were included in the study. Results: Of the 722 HFmrEF patients, 169 (23.4%) were sarcopenic. During the follow-up of sarcopenic patients, a higher rate of hospitalisation and two-year mortality was detected compared to the non-sarcopenic group (49.7% vs 33.3%, p < .001 and 23.7% vs 13.2%, p = .001, respectively). Additionally, atrial fibrillation (AF), chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF) and smoking were detected at higher rates in sarcopenic patients. In subgroup analysis, AF was found to be significantly higher in overweight/obese sarcopenia patients compared to other groups. According to Receiver operating characteristic (ROC) analysis, the sarcopenia score cut-off of 73.61 predicted mortality with 65% sensitivity and 63% specificity, and the cut-off level of 71.10 predicted hospitalisation with 68% sensitivity and 69% specificity. Conclusion: In HFmrEF patients, sarcopenia is associated with adverse events and is an important prognostic marker.