Objective This prospective descriptive correlational study aimed to examine inflammation, changes in functional status, nutritional status, and quality of life in older adults undergoing coronary artery bypass graft (CABG) surgery. Material and Methods The study sample consisted of 120 conscious and voluntary patients aged 65 years and older who underwent on-pump CABG surgery between February 2017 and January 2018 at the Department of Cardiovascular Surgery of a Ege University Medical Faculty Hospital. Data were collected at hospital admission and at the eighth postoperative week through face-to-face interviews. Data collection included sociodemographic and clinical characteristics, inflammatory markers, functional status, nutritional status, and quality of life. Data were analyzed using SPSS for Windows, version 23.0. Results At the eighth postoperative week, significant declines were observed in functional status, nutritional status, and physical quality of life compared with the preoperative period (p<0.05). Significant differences were also found in mental status scores, inflammatory markers, five times sit-to-stand test results, timed up and go test scores, handgrip strength, Katz index of activities of daily living scores, Lawton-Brody instrumental activities of daily living scores, anthropometric measurements, and mini nutritional assessment scores (p<0.05). Age was not significantly associated with functional status, nutritional status, or quality of life. Exploratory, unadjusted correlation analyses identified several low associations among inflammatory markers, functional status, nutritional status, and the physical and mental components of quality of life; none met the relevant Bonferroni-adjusted thresholds. Conclusion During the first eight weeks after CABG, older individuals in this cohort showed multidimensional postoperative changes, particularly in functional capacity, nutritional status, inflammatory profile, and quality of life. Because the study did not include a comparator group, these temporal changes should not be interpreted as effects attributable specifically to CABG. The findings indicate a need for multidisciplinary assessment and support for functional recovery, nutritional status, and overall well-being.
Objective:Trauma remains a leading cause of death and disability worldwide, with hemorrhage and traumatic brain injury being major contributors. The reverse shock index (SI) multiplied by Glasgow Coma scale (rSIG) is a novel scoring tool with potential for early identification of high-risk trauma patients. This study, the largest and first of its kind in India, aimed to assess the predictive value of rSIG for in-hospital mortality and early transfusion requirements in trauma patients. Material and Methods:This was a prospective, hospital-based study conducted at Government Medical College, Kozhikode, Kerala, from December 2022 to December 2023. A total of 536 trauma patients admitted under the department of general surgery were enrolled. Data on demographics, mechanism of injury, vital signs, GCS score, transfusion requirements, and outcomes were collected. rSIG, SI, and revised trauma score (RTS) were calculated. Receiver operating characteristic analysis was used to assess predictive performance. Results:A total of 536 trauma patients were analyzed (mean age 44.49±15.81 years; 80% males), with road traffic accidents (RTAs) accounting for 68% of cases. RTAs were significantly linked to head and multisystem injuries and contributed to 94% of deaths. Overall mortality was 11.9% (64 patients), exclusively among those with head injury. RTS showed marginally better mortality prediction than rSIG [area under the curve (AUC) 96% vs. 92%; p<0.001], while rSIG best predicted early transfusion need (AUC 91.8%; p<0.01). Conclusion:This study demonstrates that RTAs are the predominant cause of trauma, with head injury as the principal determinant of mortality. While rSIG effectively predicted early transfusion requirements, RTS showed slightly higher accuracy than rSIG in predicting mortality. rSIG remains a practical and reliable triage tool in resource-limited settings.
Objective:Mesh-based inguinal hernia repair has reduced recurrence rates; however, long-term postoperative symptoms remain clinically relevant. The Carolinas comfort scale (CCS) is a disease-specific tool developed to assess these outcomes. This study aimed to validate the Turkish version of the CCS and evaluate long-term quality of life. Material and Methods:The CCS was translated and culturally adapted using standardized procedures. A retrospective cohort of patients who underwent elective inguinal hernia repair with mesh between 2018 and 2020 was analyzed. Reliability, validity, and factor structure were evaluated using established statistical methods. Results:A total of 85 patients were included, with a median follow-up of 79 months. The Turkish CCS demonstrated excellent internal consistency (Cronbach's α=0.952), strong convergent validity with VAS (ρ=0.952, p<0.001), and significant discriminative validity for chronic pain (p<0.001). The recurrence and chronic pain rates were 10.6% and 35.3%, respectively. Conclusion:The Turkish version of the CCS is a valid and reliable instrument for assessing long-term outcomes after mesh-based inguinal hernia repair and can be used in both clinical practice and research.
