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Öğe Applicability of the ROX index in decision-making for hospitalization in COVID-19 patients(Bayrakol Medical Publisher, 2022) Kasapoglu, Umut Sabri; Selcuk, Engin Burak; Yalcinsoy, Murat; Uckac, Kadir; Sahin, Abdullah Fahri; Bentli, RecepAim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID-19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions.Material and Methods: This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated.Results: The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001).Discussion: The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.Öğe Association Between the Remnant Cholesterol Inflammation Index and Cardiac Syndrome X(Mdpi, 2026) Aktas, Ibrahim; Yasar, Erdogan; Uckac, KadirBackground and Objectives: Cardiac Syndrome X (CSX), a clinical entity within the Ischaemia with Non-Obstructive Coronary Arteries (INOCA) spectrum, is increasingly recognised as an inflammatory and systemic vascular disorder. Remnant cholesterol (RC) and inflammation are emerging contributors to residual cardiovascular risk; however, their combined role in microvascular angina remains unclear. This study aimed to evaluate the association between the remnant cholesterol inflammation index (RCII), integrating RC and high-sensitivity C-reactive protein (hs-CRP), and the clinical presence of CSX. Methods: This single-centre, retrospective observational study included 392 individuals who underwent coronary angiography between January 2023 and January 2025. The study population comprised 197 patients diagnosed with CSX and 195 control subjects with normal coronary anatomy and no objective evidence of myocardial ischaemia. RC was calculated as total cholesterol minus the sum of LDL-C and HDL-C, and RCII was derived as RC & times; hs-CRP. Importantly, invasive microvascular testing (e.g., CFR or IMR) was not performed. Logistic regression analyses were performed to identify independent predictors of CSX, and receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance. Results: Patients with CSX exhibited significantly higher levels of hs-CRP, SII, and RCII compared with controls (all p < 0.001). In the multivariable logistic regression analysis, RCII demonstrated an independent association with CSX (odds ratio 1.095, 95% confidence interval 1.060-1.131; p < 0.001). ROC curve analysis showed that RCII provided moderate but significant discrimination for CSX (area under the curve [AUC] 0.765, 95% CI 0.695-0.795). Pairwise comparisons confirmed that RCII had a significantly higher AUC than RC, hs-CRP, or SII individually. Conclusions: Higher RCII levels appear to be significantly associated with the clinical diagnosis of CSX. By integrating atherogenic remnant cholesterol burden and systemic inflammation, RCII may serve as a valuable composite biomarker for identifying residual inflammatory lipid risk. Rather than acting as a definitive diagnostic tool, these findings warrant further validation in large-scale prospective cohort studies.Öğe Clinical features and prognostic factors affecting survival of ambulatory followed COVID-19 patients aged over 65 years(Bayrakol Medical Publisher, 2022) Yalcinsoy, Murat; Selcuk, Engin Burak; Uckac, Kadir; Sahin, Abdullah Fahri; Tas, Ayse; Kasapoglu, Umut; Bentli, RecepAim: The majority of the patients with COVID-19 are followed ambulatory. Determination of prognostic factors of mortality in risky groups is essential to improve patient management. The aim of this study is to describe the clinical presentation in patients over 65 years of age with COVID-19 who are followed up at home by a physician and provide insights into the initial prognostic factors in this distinctive population. Material and Methods: This is a retrospective and observational study. Clinical records of the patients aged over 65 years who were visited by the filiation team, including a physician at home, due to the diagnosis of COVID-19 disease within 2 months were reviewed. Factors affecting mortality were examined. Results: Our study included 51 deceased (mean age: 75,1 +/- 9,0 years, 40,2% males), and 102 patients with COVID-19 who survived (mean age: 73,0 +/- 6,9 years, 68,6% male). Platelet count ( < 150.000, OR 7,26, p=0,001), CRP level ( < 4, OR 4,55, p=0,02), albumin level ( OR 3,24, p=0,02), and Troponin I level (OR 0,03, p=0,02) were the strongest predictors for death. When propensity score matching was applied, gender (male, OR 7,14, p=0,02) and platelet count (< 150.000, OR 5,34, p=0,02) were the strongest predictor Discussion: Elderly COVID-19 patients have a high mortality rate. An easily measurable and accessible platelet count may be a predictor of a bad outcome. Close follow-up and timely treatment may significantly reduce mortality in high- risk elderly patients under.
