Diyabetik Ayak Enfeksiyonlarında Hava Sıcaklığı ve Tedavi Maliyeti İlişkisinin Değerlendirilmesi

Yıl 2023, Cilt: 12 Sayı: 1, 8 - 13, 15.03.2023

Burcu Beyazgül , Çiğdem Cindoğlu

https://doi.org/10.53424/balikesirsbd.1116258

Öz

Amaç: Diyabet hastalarında ayak bakımı konusunda sorunlar yaşandığında, diyabetik ayak yaraları oluşabilmekte, tedavi edilmeyen diyabetik ayak enfeksiyonları da amputasyon ve ölüme sebep olabilmektedir. Bu çalışmada bir Üniversite Hastanesi’nde yatarak tedavi edilen diyabetik ayak hastalarında hava sıcaklığı ile tedavi maliyetlerinin değerlendirilmesi amaçlanmaktadır. Gereç ve Yöntem: Çalışma ekolojik tiptedir. Çalışmanın evrenini 2019 yılında bir hastanede yatarak tedavi edilen 123 diyabetik ayak hastası oluşturdu. Hastaların yaş, cinsiyet, diyabet süresi gibi demografik özellikleri, Wagner sınıflaması, hastanede yatış süresi, tedavi maliyeti, iklim parametreleri incelendi. Bulgular: Hastaların ortalama hastanede yatış süreleri 13.81±9.22 (min=1, max=43) gündü. Hastaların hastanede yatış maliyeti ortalamaları 2724.95±2344.04 (min=228 max=15.208) Türk Lirası (TL) idi. Yaşlı, yatış süresi uzun ve Wagner sınıflaması 3 ve üzerinde olan hastalarda tedavi maliyeti daha yüksekti (p<0.05). Hava sıcaklığının azalmasının tedavi maliyetini artırdığı bulundu (p<0.05). Sonuç: Hava sıcaklığı azalmasının enfeksiyon tedaviyi güçleştirdiği ve tedavi maliyetini artırdığı düşünülmektedir. Enfeksiyon tedavisi planlanırken, hava sıcaklığının azaldığı günlerde vazokonstruksiyon ve inflamasyonun dikkate alınması gerekmektedir.

Anahtar Kelimeler

Diyabetik ayak, Tedavi maliyeti, Hava sıcaklığı

Evaluation of the Relationship Between Air Temperature and Treatment Cost in Diabetic Foot Infections

Öz

Objective: When diabetic patients have problems in foot care, diabetic foot wounds can occur, and untreated diabetic foot infections can cause amputation and death. In this study, it is aimed to evaluate the air temperature and treatment costs in diabetic foot patients treated in a University Hospital. Materials and Methods: The study is of ecological type. The population of the study consisted of 123 diabetic foot patients who were treated in a hospital in 2019. Demographic characteristics of the patients such as age, gender, duration of diabetes, Wagner classification, length of hospital stay, cost of treatment, and climate parameters were examined. Results: The mean hospital stay of the patients was 13.81±9.22 (min:1 max:43) days. The mean hospitalization cost of the patients was 2724.95±2344.04 (min:228 max:15,208) Turkish Lira (TL). The cost of treatment was higher in patients who were elderly, had a long hospital stay, and had a Wagner classification of 3 and above (p<0.05). It was found that the decrease in air temperature increased the cost of treatment (p<0.05). Conclusion: It is thought that the decrease in air temperature complicates the treatment of infection and increases the cost of treatment. When planning the treatment of infection, vasoconstriction and inflammation should be taken into account on days when the air temperature decreases.

Anahtar Kelimeler

Diabetic foot, Treatment cost, Air temperature

Kaynakça

• Abdissa, D., Adugna, T., Gerema, U., & Dereje, D. (2020). Prevalence of diabetic foot ulcer and associated factors among adult diabetic patients on follow-up clinic at Jimma Medical Center, Southwest Ethiopia, 2019: an institutional-based cross-sectional study. Journal of diabetes research, 2020. doi: 10.1155/2020/4106383.
• Bai, L., Li, Q., Wang, J., Lavigne, E., Gasparrini, A., Copes, R., et al. (2016). Hospitalizations from hypertensive diseases, diabetes, and arrhythmia in relation to low and high temperatures: population-based study. Scientific Reports, 6(1), 1-9. doi: 10.1038/srep30283.
• Beyaz, S., Güler, Ü. Ö., & Bağır, G. Ş. (2017). Factors affecting lifespan following below-knee amputation in diabetic patients. Acta Orthopaedica et Traumatologica Turcica, 51(5), 393-397. doi: 10.1016/j.aott.2017.07.001.
• Bozkurt, F., Tekin, R., Çelen, M. K., & Celal, A. Y. A. Z. (2011). Diyabetik ayak enfeksiyonlu hastalarda Wagner sınıflaması ve kültür sonuçlarının değerlendirilmesi. Dicle Tıp Dergisi, 38(1).
• Cai, J., Meng, X., Wang, C., Chen, R., Zhou, J., Xu, X., et al. (2016). The cold effects on circulatory inflammation, thrombosis and vasoconstriction in type 2 diabetic patients. Science of The Total Environment, 568, 271-277. doi: 10.1016/j.scitotenv.2016.06.030.
• Callahan, D., Keeley, J., Alipour, H., DeVirgilio, C., Kaji, A., Plurad, D., et al. (2016). Predictors of severity in diabetic foot infections. Annals of Vascular Surgery, 33, 103-108. doi: 10.1016/j.avsg.2016.01.003.
• Eren, M. A., Güneş, A. E., Kırhan, İ., & Sabuncu, T. (2020). The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study. Acta Orthopaedica et Traumatologica Turcica, 54(2), 127. doi: 10.5152/j.aott.2020.02.518.
• Eroğlu, N. (2018). Dıabetes mellıtus’un komplikasyonları. Izmir Democracy University Health Sciences Journal, 1(2), 6-12.
• Everett, E., & Mathioudakis, N. (2018). Update on management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153-165. doi: 10.1111/nyas.13569.
• Harreiter J, Roden M. (2019). Diabetes mellitus-Definition, classification, diagnosis, screening and prevention. Wien Klin Wochenschr. 2019; 131(Suppl 1):6-15. doi: 10.1007/s00508-019-1450-4. PMID: 30980151.
• Hicks, C. W., Selvarajah, S., Mathioudakis, N., Sherman, R. L., Hines, K. F., Black III, et al. (2016). Burden of infected diabetic foot ulcers on hospital admissions and costs. Annals of Vascular Surgery, 33, 149-158. doi: 10.1016/j.avsg.2015.11.025.
• Ignatyeva, V. I., Severens, J. L., Ramos, I. C., Galstyan, G. R., & Avxentyeva, M. V. (2015). Costs of hospital stay in specialized diabetic foot department in Russia. Value in Health Regional Issues, 7, 80-86. doi: 10.1016/j.vhri.2015.09.003.
• Jalilian, M., Sarbarzeh, P. A., & Oubari, S. (2020). Factors related to severity of diabetic foot ulcer: a systematic review. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 1835. doi: 10.2147/DMSO.S256243.
• Jiang, Y., Wang, X., Xia, L., Fu, X., Xu, Z., Ran, X., et al. (2015). A cohort study of diabetic patients and diabetic foot ulceration patients in China. Wound Repair and Regeneration, 23(2), 222-230. doi: 10.1111/wrr.12263.
• Khateeb, J., Fuchs, E., & Khamaisi, M. (2019). Diabetes and lung disease: an underestimated relationship. Review of Diabetic Studies, 15(1), 1-15. doi: 10.1900/RDS.2019.15.1.
• Kim, T. G., Moon, S. Y., Park, M. S., Kwon, S. S., Jung, K. J., Lee, T., et al. (2016). Factors affecting length of hospital stay and mortality in infected diabetic foot ulcers undergoing surgical drainage without major amputation. Journal of Korean Medical Science, 31(1), 120-124. doi: 10.3346/jkms.2016.31.1.120.
• Kim, S. Y., Kim, T. H., Choi, J. Y., Kwon, Y. J., Choi, D. H., Kim, K. C., et al. (2018). Predictors for amputation in patients with diabetic foot wound. Vascular Specialist International, 34(4), 109. doi: 10.5758/vsi.2018.34.4.109.
• Lam, H. C. Y., Chan, J. C. N., Luk, A. O. Y., Chan, E. Y. Y., & Goggins, W. B. (2018). Short-term association between ambient temperature and acute myocardial infarction hospitalizations for diabetes mellitus patients: A time series study. PLoS Medicine, 15(7), e1002612. doi: 10.1371/journal.pmed.1002612.
• Li, Y. H., Luo, S. Q., Lan, L., Jin, M. G., Yang, C., He, J. Y., et al. (2017). Influence of extreme weather on years of life lost due to diabetes death in Chongqing and Harbin, China. Zhonghua liu Xing Bing xue za zhi= Zhonghua Liuxingbingxue Zazhi, 38(3), 303-308. doi: 10.3760/cma.j.issn.0254-6450.2017.03.006.
• Luan, G. J., Yin, P., Wang, L. J., & Zhou, M. G. (2018). An observational study of high air temperature on diabetes mortality in six cities in China. Zhonghua liu Xing Bing xue za zhi= Zhonghua Liuxingbingxue Zazhi, 39(5), 646-650. doi: 10.3760/cma.j.issn.0254-6450.2018.05.020.
• Niakan, M. H., Dehghankhalili, M., Pourdavood, A., Vahidi, A., Nazemi, S., Piranviseh, A., et al. (2020). Clinical outcome and determinants of amputation in a large cohort of Iranian patients with diabetic foot ulcers. The Foot, 45, 101688. doi: 10.1016/j.foot.2020.101688.
• Petrofsky JS. (2011). The effect of type-2-diabetes-related vascular endothelial dysfunction on skin physiology and activities of daily living. Journal of Diabetes Science and Technology, 5(3):657-67. doi: 10.1177/193229681100500319.
• Phung, D., Thai, P. K., Guo, Y., Morawska, L., Rutherford, S., & Chu, C. (2016). Ambient temperature and risk of cardiovascular hospitalization: An updated systematic review and meta-analysis. Science of The Total Environment, 550, 1084-1102. doi: 10.1016/j.scitotenv.2016.01.154.
• Ponirakis, G., Elhadd, T., Chinnaiyan, S., Dabbous, Z., Siddiqui, M., Al‐muhannadi, H., et al. (2020). Prevalence and management of diabetic neuropathy in secondary care in Qatar. Diabetes/Metabolism Research and Reviews, 36(4), e3286. doi: 10.1002/dmrr.3286.
• Preston, E. V., Eberle, C., Brown, F. M., & James-Todd, T. (2020). Climate factors and gestational diabetes mellitus risk–a systematic review. Environmental Health, 19(1), 1-19. doi: 10.1186/s12940-020-00668-w.
• Reardon R, Simring D, Kim B, Mortensen J, Williams D, Leslie A. (2020). The diabetic foot ulcer. Australian Journal of General Practice, 49(5):250-255. doi: 10.31128/AJGP-11-19-5161.
• Seposo, X. T., Dang, T. N., & Honda, Y. (2017). How does ambient air temperature affect diabetes mortality in tropical cities?. International Journal of Environmental Research and Public Health, 14(4), 385. doi: 10.3390/ijerph14040385.
• Staiger, H., Schaeffeler, E., Schwab, M., & Häring, H. U. (2015). Pharmacogenetics: implications for modern type 2 diabetes therapy. The Review of Diabetic Studies: RDS, 12(3-4), 363. doi: 10.1900/RDS.2015.12.363.
• Vallianou, N. G., Geladari, E. V., Kounatidis, D., Geladari, C. V., Stratigou, T., Dourakis, S. P., et al. (2021). Diabetes mellitus in the era of climate change. Diabetes & Metabolism, 47(4), 101205. doi: 10.1016/j.diabet.2020.10.003.
• Walsh, J. W., Hoffstad, O. J., Sullivan, M. O., & Margolis, D. J. (2016). Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom. Diabetic Medicine, 33(11), 1493-1498. doi: 10.1111/dme.13054.
• Weather Underground [online]. Erişim: 20.11. 2020. http://www.wunderground.com.
• WHO. Diabetes [online]. Erişim: 14.112022. https://www.who.int/health-topics/diabetes#tab=tab_1.
• Zukic, E., Gojak, R., Novakovic, A., & Gazibera, B. (2015). Predictive role of preventive measures in preventing the progression of diabetic foot. Materia Socio-Medica, 27(4), 234. doi: 10.5455/msm.2015.27.234-236.