Intensive care cost and survival analyses of traumatic brain injury

BACKGROUND
Intensive care of Traumatic Brain Injury (TBI) is associated with substantial morbidity, mortality and cost; however, there is very little published work on this topic. The purpose of this study was to examine direct costs and survival outcomes of patients with TBI admitted to an intensive care unit (ICU).
METHODS
A retrospective review of the records of Trakya University Hospital’s ICU from 2002-2006 was undertaken. Patients with TBI were determined and assessed regarding costs and survival.

RESULTS
The study group consisted of 126 patients, and 27.8% of them had been operated. Male gender (80.2%) was dominant, mean length of stay was 9.8±8.7 days, and motor vehicle injury (59.5%) was the major reason for ICU admission. Mortality rate was 50% and the Glasgow Coma Score (GCS) of the patients was 6.1±1.9. The average cost per ICU stay was US$ 4846±5084. Cost per life saved and per life-year saved were US$ 9533 and US$ 313.60, respectively. Survival rates were significantly different among injury types (p=0.010). GCS appeared to be a prognostic parameter in patient survival (Hazard Ratio: 0.643; 95%CI: 0.529-0.781; p<0.001).


CONCLUSION
Intensive care of TBI cases is characterized by high mortality and high cost.

Travmatik beyin hasarýnýn yoðun bakým maliyeti ve saðkalým analizleri

AMAÇ
Travmatik beyin hasarýnýn (TBH) yoðun bakýmý, yüksek maliyet, mortalite ve morbiditeye dayalýdýr, ancak bu konuda yayýnlanmýþ çalýþma sayýsý oldukça azdýr. Bu çalýþmanýn amacý, yoðun bakým ünitesine (YBÜ) kabul edilen TBH’li hastalarýn maliyetlerini ve saðkalým sonuçlarýný incelemektir.
GEREÇ VE YÖNTEM
2002-2006 yýllarý arasýnda Trakya Üniversitesi Hastanesi YBÜ kayýtlarý geriye dönük olarak incelendi. TBH’li hastalar saptanarak yoðun bakým maliyetleri ve saðkalým sonuçlarý deðerlendirildi.
BULGULAR
Çalýþma grubu 126 hastadan oluþmaktadýr ve bu hastalarýn %27,8’ine cerrahi giriþim uygulanmýþtýr. Erkek cinsiyet (%80,2) daha sýktýr, YBÜ’de kalýþ süresi ortalama 9,8±8,7 gündür ve motorlu taþýt yaralanmalarý (%59,5) YBÜ’ye kabuldeki en önemli nedendir. Mortalite oraný %50 ve Glaskow Koma Skoru (GKS) ortalamasý 6,1±1,9 olarak bulunmuþtur. Ortalama yoðun bakým kalýþ maliyeti 4846±5084 $’dýr. Kurtarýlan her bir yaþam maliyeti ve kazanýlan her bir yaþam yýlý maliyeti sýrasýyla 9533 $ ve 313,6 $ olarak hesaplandý. Yaralanma tipleri arasýnda saðkalým oranlarý istatistiksel anlamlý farklý bulundu (p=0,010). GKS’nin olgularýn saðkalým sonuçlarýný kestirmede prognostik bir faktör olduðu saptandý (Hazard Oraný: 0,643; %95 GA: 0,529-0.781; p<0,001).
SONUÇ
TBH’nin yoðun bakým maliyetleri oldukça yüksek bulunmuþtur, ayrýca yüksek düzeyde mortalite oranýna da sahiptir.