Ulus Travma Acil Cerrahi Derg. 2012; 18(6): 501-506 | DOI: 10.5505/tjtes.2012.06791

Ýzole kafa travmalý olgularda enfeksiyon: risk etkenleri ve tedavi maliyeti üzerine etkisi

Alp Arslan¹, Barýþ Birgili², Ahmet Tolgay Akýncý³, Osman Þimþek³, Cumhur Kýlýnçer^3
1Saðlýk Bakanlýðý Servergazi Devlet Hastanesi, Denizli
²Saðlýk Bakanlýðý Uzunköprü Devlet Hastanesi, Edirne
³Trakya Üniversitesi Týp Fakültesi Beyin ve Sinir Cerrahisi Ana Bilim Dalý, Edirne

Amaç: Ýzole kafa travmalý hastalarda enfeksiyonun risk etkenlerini ve tedavi maliyeti üzerine etkisini saptamak.
Gereç ve Yöntem: Trakya Üniversitesi Týp Fakültesi Hastanesi’nde 2001–2007 yýllarý arasýnda 72 saatten uzun süre hastanede yatan izole kafa travmalý 299 olgunun verileri geriye yönelik olarak incelendi. Olgulara ait yaþ, cinsiyet, ilk nörolojik muayene, radyolojik bulgular, yatýþ süresi, ameliyat gereksinimi, enfeksiyonun maliyeti, toplam maliyet ve çýkýþ skoru deðerleri belirlendi. Olgular enfeksiyon geliþimine göre iki gruba ayrýlarak, risk etkenleri ve enfeksiyonun tedavi maliyeti üzerine etkisi açýlarýndan karþýlaþtýrýldý.
Bulgular: Enfeksiyon geliþen grupta giriþ Glasgow Koma Ölçeði deðerleri ortalamasýnýn daha düþük; anizokori, ýþýk refleksi kaybý, taraf bulgusu, kaide kýrýðý, subdural hematom ve serebral ödem bulgularýnýn daha sýk; hastanede yatýþ süresinin yaklaþýk dört kat, toplam tedavi maliyetinin yaklaþýk on kat ve ölüm oranýnýn anlamlý derecede daha yüksek olduðu saptandý. Hafif kafa travmalý hastalarda, enfeksiyon geliþen grupta geliþmeyen gruba kýyasla yaþ ortalamasýnýn daha yüksek olduðu saptandý.
Sonuç: Ýzole kafa travmalý hastalarda enfeksiyon geliþmesi için bazý risk etkenleri vardýr ve enfeksiyon geliþmesi ile hastanede yatýþ süresi, toplam tedavi maliyeti ve ölüm oraný artmaktadýr.

Anahtar Kelimeler: Çýkýþ durumu, enfeksiyon, kafa travmasý, risk etkenleri, tedavi maliyeti, yatýþ süresi

---

Infection in the patients with isolated head injury: risk factors and the impact on treatment cost

Alp Arslan¹, Barýþ Birgili², Ahmet Tolgay Akýncý³, Osman Þimþek³, Cumhur Kýlýnçer^3
1Ministry Of Health, Servergazi Government Hospital, Denizli, Turkey
²Ministry Of Health, Uzunköprü Government Hospital, Edirne, Turkey
³Trakya Univercity Medical Faculty Department of Neurosurgery, Edirne, Turkey

Objective: To determine risk factors and the impact on treatment cost of infection, for patients with isolated head injury.
Materials and Methods: Data acquired from 299 patients with isolated head trauma hospitalized for more than 72 hours at Trakya University Medical Faculty Hospital between years 2001-2007, were evaluated retrospectively. Data including age, gender, initial neurological examination, radiological findings, duration of hospitalization, need for surgery, cost of infection treatment, total cost of care and outcome scores were determined. Two groups divided according to the development of infection are compared for risk factors and the impact of infection on the cost of treatment.
Results: On the group of patients with infection the mean Glasgow Coma Scale value at delivery was lower; anisocoria, light reflex loss, lateralized deficit, skull base fracture, subdural hematoma, cerebral edema findings were more frequent; a four times longer hospital stay, a ten times higher total cost and a significantly increased mortality rate have been found. For the patients with light head injury, on the group of patients with infection the mean age has found to be higher.
Conclusion: For patients with isolated head injury, there are some risk factors for the development of infection which increases the hospitalization time, the total cost of care and the mortality rates.

Keywords: Cost of treatment, head trauma, infection, length of stay, outcome, risk factors

---

ATIF KOPYALA