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  • Küçük Resim Yok
    Öğe
    Cost analysis of nosocomial infections in a tertiary care referral hospital's neurology intensive care unit: A case-control study [Bir nöroloji yoğun bakım ünitesinde hastane enfeksiyonu maliyet analizi: Olgu kontrol çalışması]
    (Ege University Press, 2015) Taner Ş.; Güler A.; Şİrİn H.; Pullukçu H.; Arda B.
    Aim: The purpose of this study is to overview nosocomial infections (NI), to determine risk factors and to evaluate the clinical and financial impact of NI on direct hospital cost among neurology intensive care unit (NICU) patients in a tertiary-care referral hospital. Material and Methods: A retrospective case control study was performed. The sample size was calculated to be at least 51 per group. A list of the last 55 patients who acquired an infection in NICU was obtained from infection control committee. These patients were matched with uninfected patients according to age, sex, diagnosis. The data were collected from patient files, accounting records. Results: A total of 79 NI occurred in 55 cases. The most common NI were pneumonia (48%), catheter related urinary tract infection (39%). Acinetobacter baumannii (25%) is most commonly responsible for NI. NI were detected less in patients who were conscious, nonintubated, without blood transfusion, tracheostomy, urinary catheter or mechanical ventilation. The mortality ratio was 53.1% in cases and 30.8% in controls. The excess costs of NI were $7121.15 and extra length of stay was 26.9 days. Although reimbursement took longer than six months, the Social Security Institution paid back the total billing amount. Conclusion: Given the impact on monetary and health costs of NI, measures to prevent NI in the hospital are strongly recommended for patient safety and for hospital reputation. NICUs in tertiary care referral facilities do not cause financial burden; on the contrary, they provide an opportunity to balance the budget. © 2015, Ege University Press. All rights reserved.
  • Küçük Resim Yok
    Öğe
    The effect of onabotulinum toxin-A on frequency of headache, severity of headache and health related life-quality at patients with resistant chronic migraine [Onabotulinum toksin tip-A tedavisinin dirençli kronik migren hastalarında baş ağrısı sıklığı, baş ağrısı şiddeti ve sağlığa bağlı yaşam kalitesi üzerine etkisi]
    (Ege University Press, 2015) Şİrİn T.C.; Acarer A.; Şİrİn H.
    Introduction: Resistant chronic migraine (RCM) causes a considerable decline in the quality of life and work efficiency of the patients and ultimately might even decrease their socioeconomic level because of severe and permanent headaches. In addition, migraine attacks force patients to rush to the emergency rooms, which leads to overcrowding and exhaustion of medical resources. In this study, the effect of onabotulinum toxin A (OBoNT-A) treatment was assessed in terms of efficiency and the quality of life retrospectively at patients with RCM. Method: 15 patients with RCM who were given 155 IU OBoNT-A treatment twice in 12 weeks have been studied retrospectively in terms of change of headache frequency, severity, and the health related quality of life scores (physical function, physical restriction, pain, general health, vitality, social function, emotion and mental health categories) for 24 weeks. Response to treatment is identified as ?30% decrease in headache frequency while the change in the quality of life was determined with short form-36 before and after treatment. Findings: Average headache frequency was 26.3 day/month before treatment. After 24 weeks, 93% of the patients were responsive to the treatment. After OBoNT-A treatment average headache frequency decreased to 16,6 day/month in 12 weeks and to 17,8 day/month in 24 weeks (p<0.001). Average health related quality of life scores before treatment were under 50%, while all the health related quality of life scores improved after treatment(p<0.001). At the end of 24 weeks, headache severity significantly decreased (p<0.001). Conclusion: OBoNT-A is an effective treatment in patients with RCM and it must be considered a first line treatment for RCM patients considering the cost-effectiveness researches. © 2015, Ege University Press. All rights reserved.