Göðüs Hastanesi Dergisi. 2009; 23(1): 17-23

PULMONER VENÖZ TROMBOEMBOLÝLÝ HASTALARDA TANI SÜRESÝ VE MALÝYET ANALÝZÝ

Pelin DURU ÇETÝNKAYA¹, Serir AKTOÐU¹, Enver YALNIZ¹
Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Kliniði, Ýzmir

Taný konulmamýþ pulmoner venöz tromboembolide (VTE), mortalite %30'a ulaþmakta ancak doðru taný ve uygun tedavi ile bu oran %3'e kadar düþmektedir. VTE'nin akla getirilip en kýsa sürede taný konulmasý çok önemlidir. Bu çalýþmanýn amacý VTE'li olgularýn taný süresini ve bunu etkileyen faktörleri, hastanede yatýþ sürelerini araþtýrmak, bu olgularýn maliyet analizlerini yapmaktýr. Mayýs 2005-Aralýk 2007 tarihleri arasýnda, VTE tanýsý alan 51 olgu retrospektif olarak çalýþmaya alýndý. Ortalama taný süresi 3.6 ± 2.7 (1-14) gün ve ortalama hastanede yatýþ süresi 15.5 ± 6.7 (6-40) gündür. Taný konup, tedavileri baþlanan hastalarýn toplam maliyeti ortalama 1730.2 ± 1188.6 Türk Lirasýdýr (TL) Olgularýn toplam maliyeti incelendiðinde %47.05'inin tetkik, %36.56'sýnýn tedavi, %14.14'ünün yatak ücreti ve %2.24'ünün ise muayene ücreti olduðu saptanmýþtýr. Olgularýn %49'unda lökositoz, %21.6'sýnda ateþ vardýr. Ortalama lökosit deðeri 16.100 ± 8353'dür. Lökositozu olan hastalarýn maliyeti anlamlý olarak daha yüksek bulunmuþtur (p=0.041). Pulmoner VTE'li hastalarda maliyetin önemli bir bölümünü özellikle görüntüleme yöntemleri oluþturmaktadýr. Lökositozun saptanmasý hastalarda maliyetin artmasýna neden olmaktadýr. Ateþ ve lökositoz, hekimi pulmoner VTE tanýsýndan uzaklaþtýrmamalýdýr.

Anahtar Kelimeler: Venöz tromboembolizm, taný süresi, lökositoz, maliyet analizi

---

THE FACTORS EFFECTING DIAGNOSIS TIME AND THE COST ANALYSIS IN PATIENTS WITH PULMONARY VENOUS THROMBOEMBOLISM

Pelin DURU ÇETÝNKAYA¹, Serir AKTOÐU¹, Enver YALNIZ¹
Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Kliniði, Ýzmir

In veno us thromboembolism (VTE), the mortality rate in undiagnosed patients extends up to 30%, however this rate can be reduced to 3% with a correct diagnose and an appropriate treatment. The consideration and early diagnosis of VTE are very important issues. The aim of this study is to investigate the diagnosis time, the factors affecting the diagnosis time and the length of hospital stay and to perform a cost analysis of patients with VTE. Fifty one cases with VTE were admitted to study retrospectively between May 2005 and December 2007. The mean of diagnosis time was 3.6 ± 2.7 (1-14) day and the length of hospital stay was 15.5 ± 6.7 (6-40) day. The mean total cost of patients who were diagnosed and started to treat was 1730.2 ± 1188.6 Turkish Lira (TL). When the cost of patients was examined, it was detected that 47.05% for diagnostic procedures, 36.56% for treatment, 14.14% for bed cost and 2.24% for examination fee of doctor. The patients had leucocytosis (49%) and fever (21.6%). The mean of le ucocytes value was 16.100 ± 8353. A significantly higher cost was observed in patients with leucocytosis (p=0.041). The important part of the cost in patients with VTE is especially scaning methods. The detection of leucocytosis caused to increase of the cost in patients. The presence of fever and leucocytosis in a patient should not exclude the diagnosis of VTE.

Keywords: Venous thromboembolism, diagnosis time, leukocytosis, cost analysis

---

ATIF KOPYALA