Hastaneye yatan toplumda gelişen pnömoni, hastanede gelişen pnömoni ve ventilatör ile ilişkili pnömoni olgularının karşılaştırılması
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Pnömoni tüm dünyada en önemli mortalite ve morbidite nedenlerindendir. Bu çalışmada toplumda gelişen pnömoni ve hastanede gelişen pnömonideki tedavi başarısı, 30 ve 90 günlük mortaliteye etki eden faktörleri, skorlama sistemleri ve maliyeti karşılaştırmayı amaçladık. Trakya Üniversitesi Tıp Fakültesi Hastanesi’ne 2019 yılında yatırılarak izlenen toplumda ve hastanede gelişen pnömoni olguları prospektif olarak izlendi. Hastaların demografik özellikleri ve tedavi başarıları deskriptif istatistikle, hastalık mortalitesi ve mortaliteye etki eden faktörler Kaplan Meier ve Cox regresyon analizi yöntemi ile incelendi. Çalışmaya 60 toplumda gelişen pnömoni, 23 hastanede gelişen pnömoni hastası dahil edildi. Toplumda gelişen pnömoni olgularının 40’ı (%66,7) erkek, ortalama yaşı 63,6 ± 18,8 olarak saptandı. Hastaların 53’ünde (%88,3) tedavi başarılı olurken, 7 hasta hayatını kaybetti. Toplumda gelişen pnömonide Pnömoni ağırlık indeksi ve CURB-65 30 ve 90 günlük mortaliteyi belirlemede anlamlı olduğu tesbit edilirken; I-ROAD yalnızca 30 günlük mortalite üzerinde anlamlı bulundu. Bunun dışında dakika solunum sayısı ve saturasyon değerleri 30 günlük mortalite üzerinde anlamlı bulundu (p<0.001, p<0.001). Hastanede gelişen pnömonide ise tedavi 10 hastada (%43,5) başarılı olarak bulunmuştu. I-ROAD skorlama sistemi 30 ve 90 günlük mortaliteyi belirlemede anlamlı olarak bulundu. Ortalama pnömoni maliyetleri toplumda gelişen pnömoni ve hastanede gelişen pnömonide sırasıyla 763,59 ± 769,67 $ ve 2991,09 ± 2988,21 $ olarak saptandı. Toplumda gelişen pnömonilerde tedavi başarısı daha yüksektir. Toplumda gelişen pnömonili hastalarda Pnömoni ağırlık indeksi, hastanede gelişen pnömonide ise I-ROAD mortaliteyi belirlemede daha anlamlıdır. Hem toplumda gelişen pnömoni hem hastanede gelişen pnömoni maliyeti yüksek hastalıklar olarak değerlendirilmiştir. Ülkemizde bu konuda yapılacak mortalite ve maliyet çalışmaları sağlık sistemini yönlendirebilmesi açısından önem arz etmektedir.
SUMMARY Pneumonia is one of the most important causes of mortality and morbidity worldwide. In this study, we aimed to compare the treatment success in the community and hospitalacquired pneumonia, factors affecting 30 and 90-day mortality, scoring systems and cost. Community-acquired and hospital-acquired pneumonia cases that were hospitalized in Trakya University Medical Faculty Hospital in 2019 were prospectively monitored. Demographic features and treatment success of the patients were analyzed by descriptive statistics, and factors affecting mortality and mortality were evaluated by the Kaplan Meier and Cox regression analysis method. The study included 60 community-acquired pneumonia cases and 23 hospital-acquired pneumonia cases. 40 (66.7%) of the community-acquired pneumonia cases were male and the mean age was 63.6±18.8. Treatment was successful in 53 (88.3%) of the patients, while 7 patients died. While it is determined that community-acquired pneumonia is significant in determining Pneumonia severity index and CURB-65 30 and 90-day mortality; I-ROAD was found only significant on 30-day mortality. Respiratuar rate and saturation values were also significant on 30-day mortality (p <0.001, p <0.001). In hospital-acquired pneumonia, the treatment was successful in 10 patients (43.5%). I-ROAD was found to be significant in determining 30 and 90-day mortality. Average pneumonia costs were $ 763.59±769.67 in community-acquired pneumonia and $ 2991.09±2988.21 in hospital-acquired pneumonia. Treatment success is higher in community-acquired pneumonia. Pneumonia severity index is more significant in determining mortality in community-acquired pneumonia and I-ROAD in hospital-acquired pneumonia. Both community-acquired and hospital-acquired pneumonia were evaluated as high-cost diseases. Mortality and cost studies to be carried out in our country are important in terms of directing the health system.
SUMMARY Pneumonia is one of the most important causes of mortality and morbidity worldwide. In this study, we aimed to compare the treatment success in the community and hospitalacquired pneumonia, factors affecting 30 and 90-day mortality, scoring systems and cost. Community-acquired and hospital-acquired pneumonia cases that were hospitalized in Trakya University Medical Faculty Hospital in 2019 were prospectively monitored. Demographic features and treatment success of the patients were analyzed by descriptive statistics, and factors affecting mortality and mortality were evaluated by the Kaplan Meier and Cox regression analysis method. The study included 60 community-acquired pneumonia cases and 23 hospital-acquired pneumonia cases. 40 (66.7%) of the community-acquired pneumonia cases were male and the mean age was 63.6±18.8. Treatment was successful in 53 (88.3%) of the patients, while 7 patients died. While it is determined that community-acquired pneumonia is significant in determining Pneumonia severity index and CURB-65 30 and 90-day mortality; I-ROAD was found only significant on 30-day mortality. Respiratuar rate and saturation values were also significant on 30-day mortality (p <0.001, p <0.001). In hospital-acquired pneumonia, the treatment was successful in 10 patients (43.5%). I-ROAD was found to be significant in determining 30 and 90-day mortality. Average pneumonia costs were $ 763.59±769.67 in community-acquired pneumonia and $ 2991.09±2988.21 in hospital-acquired pneumonia. Treatment success is higher in community-acquired pneumonia. Pneumonia severity index is more significant in determining mortality in community-acquired pneumonia and I-ROAD in hospital-acquired pneumonia. Both community-acquired and hospital-acquired pneumonia were evaluated as high-cost diseases. Mortality and cost studies to be carried out in our country are important in terms of directing the health system.
Açıklama
Anahtar Kelimeler
Pnömoni, Pneumonia
