Ulus Travma Acil Cerrahi Derg. 2013; 19(5): 429-433 | DOI: 10.5505/tjtes.2013.78910

Suriye’deki çatýþmalarýn acil servise yansýyan yönü ve hastane maliyetlerinin deðerlendirilmesi

Ali Karakuþ¹, Erhan Yengil², Seçkin Akkücük³, Cengiz Cevik⁴, Cem Zeren⁵, Vedat Uruc^6
1Mustafa Kemal Üniversitesi, Týp Fakültesi, Acil Týp Ad. Hatay, Türkiye
²Mustafa Kemal Üniversitesi, Týp Fakültesi, Aile Hekimliði Ad. Hatay, Türkiye
³Mustafa Kemal Üniversitesi, Týp Fakültesi, Genel Cerrahi Ad. Hatay, Türkiye
⁴Mustafa Kemal Üniversitesi, Týp Fakültesi, Kulak Burun Boðaz Ad. Hatay, Türkiye
⁵Mustafa Kemal Üniversitesi, Týp Fakültesi, Adli Týp Ad. Hatay, Türkiye
⁶Mustafa Kemal Üniversitesi, Týp Fakültesi, Ortopedi Ad. Hatay, Türkiye

AMAÇ: Bu çalýþmada, Suriye’de yaþanan çatýþmalar sonrasý hastanemize getirilen olgularýn demografisi, klinik özellikleri ve yapýlan harcamalarýn deðerlendirilmesi amaçlandý.
GEREÇ VE YÖNTEM: Bu amaçla Haziran 2011-Temmuz 2012 yýllarý arasýndaki 14 aylýk dönemde hastanemize getirilen 1355 Suriyeli olgunun acil servis giriþi olan 482’si çalýþmaya alýndý. Hastalarýn bilgisayar verileri geriye dönük olarak incelendi.
BULGULAR: Olgularýn 428’i (%88.8) erkek, 54’ü (%11.2) kadýn, yaþ ortalamalarý 30.4±14.9 yýl (min: 1, maks: 79), erkeklerin yaþ ortalamasý 30.8±17.2 yýl (min: 1, maks: 79), kadýnlarýn yaþ ortalamasý ise 27.3±16.9 yýl (min: 1.5, maks: 66) olarak belirlendi, cinsiyet bakýmýndan aralarýnda istatistiksel olarak anlamlý bir fark saptandý (p=0.007). Olgularýn en çok 21-30 yaþ grubunda (%41.1) olduðu belirlendi. En fazla baþvurunun 159 (%33) kiþiyle Haziran 2011, en az ise beþ kiþi (%1) ile Eylül 2011’de olduðu tespit edildi. Hastalar 112 Acil Servis ambulanslarý ile çevre ilçe hastaneleri ve kamplardan getirildi. Acil servise baþvuru sebebi en sýk 338 olgu (%70.1) ile ateþli silah yaralanmasý idi. En sýk konulan taný ise ekstremite yaralanmasýydý (153 olgu, %31.7). Adli olgu sayýsý 364 (%75.5) tespit edildi. Yüz otuz altý (%28.2) hastanýn acil servisde takip ve tedavisi yapýldý. Hastalar en sýk ortopedi ve travmatoloji bölümüne yatýrýlarak tedavi edildi (146 olgu, %30.3). Ortalama yatýþ süresi 9.9 gün (1-141 gün) idi. 456 olgu (%94.6) taburcu edilirken, 22 olgu (%4.6) öldü, dört olgu (%0.8) ise sevk edildi. Olgularýn maliyeti ortalama 3723 TL (min: 5 TL, maks: 69556 TL) olarak bulundu. Sürekli deðiþkenler arasý korelasyon testi yapýldýðýnda maliyeti ve yatýþ süresi arasýnda pozitif korelasyon saptandý (p=0.000).
TARTIÞMA: Getirilen olgular içinde genç erkek ve ateþli silah yaralanmasý olgularýnýn çokluðu dikkat çekti. Olgularýn çoðunluðu uygun takip ve tedavi sonrasýnda taburcu edildi. Alýnacak tedbirler sonrasýnda bu kötü sonuçlar engellenebilecek, önlenebilir maliyetler ortaya çýkmayacak ve ülke bütçelerinin zarar görmesi önlenebilecektir.

Anahtar Kelimeler: Önlenebilir maliyet, ateþli silah yaralanmasý, Suriyeli olgu.

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The reflection of the Syrian civil war on the emergency department and assessment of hospital costs

Ali Karakuþ¹, Erhan Yengil², Seçkin Akkücük³, Cengiz Cevik⁴, Cem Zeren⁵, Vedat Uruc^6
1Mustafa Kemal University, Faculty Of Medicine, Department Of Emergency Medicine, Hatay, Turkey.
²Mustafa Kemal University, Faculty Of Medicine, Department Of Family Medicine, Hatay, Turkey.
³Mustafa Kemal University, Faculty Of Medicine, Department Of General Surgery, Hatay, Turkey.
⁴Mustafa Kemal University, Faculty Of Medicine, Department Of Otorhinolaryngology, Hatay, Turkey.
⁵Mustafa Kemal University, Faculty Of Medicine, Department Of Forensic Medicine, Hatay, Turkey.
⁶Mustafa Kemal University, Faculty Of Medicine, Department Of Orthopedics, Hatay, Turkey.

BACKGROUND: In the present study, it was aimed to assess the demographics, clinical features, and treatment costs of cases referred to our hospital after the Syrian civil war.
METHODS: Of 1355 Syrian civil war victims referred to our hospital during the 14-month period between June 2011 and July 2012, 482 cases presenting to the emergency department were included in the study. The electronic data of these patients were retrospectively analyzed.
RESULTS: Of 482 cases, 428 were male (88.8%) and 54 (11.2%) were female, with a mean age of 30.4±14.9 years (1-79 years). The mean age was 30.8±17.2 years (1-79 years) in males and 27.3±16.9 years (1.5-66 years) in females. There was a significant difference in terms of sex (p=0.007). It was found that the majority of the cases (41.1%) were aged 21-30 years. The highest number of admissions was recorded in June 2011 (159 patients, 33%), whereas the lowest number of admissions was in September 2011 (5 patients, 1%). All cases were transported to our hospital from nearby district hospitals and camps by emergency medical services. The most frequent presenting complaint was gunshot injury (338 cases, 70.1%). The most common diagnosis was extremity injury (153 cases, 31.7%). The number of forensic cases was found as 364 (75.5%). Of all the cases, 136 cases (28.2%) were managed in the emergency service, and the remaining cases were admitted to other services. They were most frequently admitted to the orthopedics ward (146 cases, 30.3%). The mean length of the hospital stay was 9.9 days (1-141).Overall, 456 cases (94.6%) were discharged, 22 cases died, and 4 cases were transferred to other facilities. The mean cost per case was estimated as 3723Turkish lira (TL) (15-69556). A positive correlation was found between cost and length of hospital stay.
CONCLUSION: Among all Syrian cases, the majorities of young males and gunshot injuries was striking. Most of the cases were discharged after appropriate management. Preventive measures can avoid these negative outcomes and so avoidable costs will not occur, and this can preclude the damage to the budgets of the countries.

Keywords: Avoidable costs, gunshot injury, Syrian case.

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ATIF KOPYALA