Mehmet YILDIRIM, Emin GEMCİOĞLU, Rıfat BOZKUŞ, Şuayip BİRİNCİ, Arzu TOPELİ, Naim ATA
Acta Medica - 2026;57(3):273-282
Objective: Improvements in survival have led to a growing adult population with cystic fibrosis (CF), increasing the relevance of intensive care unit (ICU) management in this group. However, nationwide data on ICU utilization and outcomes in CF remain limited. Materials and Methods: This nationwide retrospective cohort study included all adults (>=18 years) with CF admitted to ICUs in Türkiye between 2018 and 2023. Data were obtained from the Turkish Ministry of Health National Electronic Database, covering all ICU levels and hospital types. Demographic characteristics, admission diagnoses, comorbidities, ICU interventions, APACHE II scores, and outcomes were analyzed. The primary outcome was ICU mortality. Results: A total of 126 adults with CF were admitted to ICUs during the study period. Most admissions occurred in Level 3 ICUs (62.7%) and mixed ICUs (38.8%). More than half were concentrated in the Marmara region (50.8%). Median age was 30 years [23-41], and overall ICU mortality was 32.5%. Non-survivors were older and had higher APACHE II scores than survivors (21 [12-28] vs. 7 [3-13], p<0.01). Sepsis was more frequent among non-survivors (31.7% vs. 15.3%, p=0.03), and cardiovascular comorbidities were associated with mortality. Non-invasive mechanical ventilation was commonly used but was not associated with ICU mortality. Conclusions: In this nationwide cohort, ICU mortality among adults with CF was comparable to contemporary international reports and was primarily associated with acute illness severity and infectious complications. These findings provide the first national overview of ICU care in CF in Türkiye and highlight the importance of severity-based risk stratification in critically ill adults with CF.
