Toplumdan Kökenli Pnömoni Nedeniyle Hastanede Yatan Yaşlı Hastaların (> 65 Yaş) Özellikleri ve Ekonomik Yükü

Year 2022, Volume: 11 Issue: 1, 84 - 91, 29.04.2022

Nuran Katgı , Pınar Çimen Aysu Ayrancı , Fevziye Fatma Tuksavul

https://doi.org/10.47493/abantmedj.969524

Abstract

Amaç: Toplum kökenli pnömoni (TKP) nedeniyle yaşlı hastaların hastane yatış sıklığı yüksektir ve hastane maliyetini arttırır. TKP nedeniyle hastanede yatan yaşlı hastaların (>65 yaş) özellikleri ve maliyeti analiz edildi.

Gereç ve Yöntemler: 01.01.2015-15.11.2017 tarihleri arasında pnömoni nedeniyle hastanede yatan 180 hastanın retrospektif analizi yapıldı. TKP nedeniyle hastanede yatan 65 yaş üstü hastalar yatış gününden itibaren 30 güne kadar mortalite için takip edildi. Taburcu olanlar ise 90 güne kadar takip edildi. Hastane maliyeti analiz edildi.

Bulgular: 115 (%60) hasta 65 yaş üstüydü. Hastaların %82.4'üne oksijen tedavisi, %27.8'ine noninvaziv mekanik destek uygulandı. %16.5 hastada yoğun bakım desteğine gerek duyuldu. Pnömoni ciddiyet indeksi (PCİ) yaşla birlikte arttı (p=0.021). Otuz günlük mortalite oranı artmış yaşla ilişkiliydi (p=0.048). Toplam tedavi maliyetinin yüksek PCİ ile arttığı izlendi (p=0.003). Yüksek PCİ ve toplam maliyet özellikle mortalite ile ilişkiliydi (p=0.000). Otuz günlük mortalite oranı ileri yaşla ilişkili bulunurken (p=0.048) 60 ve 90 günlük mortalite oranlarında bu ilişki gösterilemedi (p=0.244, p==0.469). 30 günlük mortalite oranı kronik obstrüktif akciğer hastalığı (KOAH) ve malignitesi olanlarda yüksekti (p=0.038, p=0.040). Hastane maliyeti ve ek hastalıklar arasında bir ilişki bulunamadı (p>0.05).

Sonuç: TKP yaşlı hastalarda yaygın bir hastane yatış nedenidir. Yaşlı hastalarda TKP yüksek ölüm oranı ve artmış tedavi maliyeti nedeniyle daha önemlidir. Erken ve yeterli tedavi için risk faktörü olan yaşlı hastaların tespiti önemlidir.

Keywords

yaşlı, hastane yatışı, toplum kökenli pnömoni, maliyet

Characteristics and Economic Burden of Hospitalized Elderly Patients (> 65 Years) Due to Community-Acquired Pneumonia

Abstract

Objective: The prevalence hospitalization of elderly patients due to community acquired pneumonia (CAP) is high and increases the hospital cost. Characteristics and economic burden of hospitalized elderly patients (>65years) due to CAP were analyzed.

Materials and Methods: We performed a retrospective analysis of the 180 patients who were hospitalized with pneumonia between 01.01.2015-15.11.2017. Patients older than 65 years old and hospitalized for CAP were followed up for up to 30 days from initial hospitalization for mortality and the patients who were discharged were followed up to 90 days of initial hospitalization. Hospital costs were analyzed.

Results: 115(60%) patients were older than 65. 82.4% of the patients received oxygen therapy and 27.8% of them received noninvasive mechanical support. 16.5% of the patients needed intensive care support. PSI was increased with age(p=0.021). Thirty-day mortality was related with older age(p=0.048). Total treatment costs were increased with high PSI (p=0.003). Increased PSI and total cost were significantly associated with mortality (p=0.000). Thirty-day mortality was related with older age(p=0.048), but age was not related with 60-day and 90-day mortality (p=0.244, p=0.469). 30-day mortality was high in patients with COPD and malignancy (p=0.038, p=0.040). No associations were found between total hospital cost and additional diseases (p>0.05).

Conclusion: CAP is a common cause of hospitalization in elderly patients. Older patients had more severe CAP which caused high mortality and high treatment costs; so it is important to identify elderly patients with risk factors for early adequate treatment.

Keywords

Elderly, hospitalization, community acquired pneumonia, cost

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