KARDİYAK RİSK FAKTÖRLERİNİN HASTANEDE YATIŞ SÜRESİNE ETKİLERİ ÜZERİNE BİR UYGULAMA1

Dünyada ve ülkemizde, en önemli mortalite ve morbidite nedeni olan iskemik kalp hastalıklarının tedavi maliyetleri, yaşanan teknolojik gelişmelere paralel olarak artmaktadır. Bu nedenle, iskemik kalp hastalıkları nedeniyle tedavi gören hastaların, kardiyoloji kliniği servis ve yoğun bakımında kalma sürelerinin kestirimine imkân veren istatistiksel modellerin geliştirilmesi önem arz etmektedir. Çalışmanın sonucunda, istatistiksel olarak anlamlı bulunan etkenlere göre kardiyoloji kliniğinde yatan hastalar için servis ve yoğun bakımda kalınan gün sayılarının kestirimine imkân veren istatistiksel modeller elde edilmiştir.

AN APPLICATION ON THE IMPACTS OF CARDIAC RISK FACTORS ON THE LENGTH OF HOSPITAL STAY AND TREATMENT EXPENSES

Treatment costs of ischemic heart diseases that are the most important cause of mortality and morbidity in the world and in our country are increasing in parallel with technological developments. Therefore, it is important to develop statistical models which enable prediction of the length of stay in the hospital with ischemic heart diseases treated in cardiology unit and intensive care unit. As a result, statistical models were obtained in order to predict the length of stay in cardiology unit and intensive care unit based on the statistically significant factors in the patients hospitalized in the cardiology clinic.

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  • ANDERSON. Jeffrey L.; "ST Segment Elevation Acute Myocardial Infarction and Complications of Myocardial Infarction", Goldman's Cecil Medicine, Ed. Lee Goldman, Andrew I. Schafer, Elsevier Saunders, 24th Edition, 2012, (Erişim) https://www.clinicalkey.com 08.09.2013, s.434-448.
  • ANTMAN. Elliott M.; "ST-Segment Elevation Myocardial Infarction: Pathology, Pathophysiology, and Clinical Features", Braunwald's Heart Disease A Textbook of Cardiovasculer Medicine, Ed. Robert O. Bonow vd., Elsevier Saunders, 9th Edition, 2012, (Erişim) https://www.clinicalkey.com, 19.09.2013, s.1087-1110.
  • BARBASH. Gabriel I., vd.; "Significance of Smoking in Patients Receiving Thrombolytic Therapy for Acute Myocardial Infarction. Experience Gleaned from The International Tissue Plasminogen Activator/Streptokinase Mortality Trial",Circulation, Vol:87, No:1, January, 1993, (Erişim) http://circ.ahajournals.org, 13.11.2013, s.53-58.
  • BARBASH. Gabriel I., vd.; "Evaluation of Paradoxic Beneficial Effects of Smoking in Patients Receiving Thrombolytic Therapy for Acute Myocardial Infarction: Mechanism of The "Smoker's Paradox" From The GUSTO-I Trial, with Angiographic Insights" Journal of the American College of Cardiology, Vol:26, No:5, November, 1995, (Erişim) http://www.sciencedirect.com, 13.11.2013. s.1222-1229.
  • BERGER. Alan K., vd.; "Relation of Length of Hospital Stay in Acute Myocardial Infarction to Postdischarge Mortality", The American Journal of Cardiology, http://www.sciencedirect.com, 10.08.2013, s.428-434. No:4, February, 2008,
  • CARPENTER. John P., MANSFIELD Richard; "Kronik, Kararlı İskemik Kalp Hastalığına Yaklaşım", Ed. Henry J. Purcell, Paul R. Kalra, Kardiyoloji, Çev. Ed. Barış İlerigelen, İstanbul, İstanbul Tıp Kitapevi, 2009, s.82-102.
  • CHIN, Chee Tang, vd.; "Trends and Predictors of Length of Stay after Primary Percutaneous Coronary Intervention: A Report from The CathPCI Registry" American Heart Journal, 2011, Vol:162, Issue:6, (Erişim) https://www.clinicalkey.com, 05.09.2013, s.1052-1061.
  • CLAEYS. Marc J., vd.; "Inter-hospital Variation in Length of Hospital Stay After ST-elevation Myocardial Infarction: Results from The Belgian STEMI Registry, Acta Cardiologica, 2013, 68.3, (Erişim) http://eds.b.ebscohost.com, 05.09.2013, 235-239.
  • EVERY. Nathan R., vd.; "Length of Hospital Stay After Acute Myocardial Infarction in The Myocardial Infarction Triage and Intervention (MITI) Project Registry", Journal of the American College of Cardiology, Vol:28, No:2, August, 1996, (Erişim) http://www.sciencedirect.com, 13.08.2013, s.287-293.
  • FOX. Keith A. A.; "Kronik Stabil Koroner Hastalığı", Çev. V. Gökhan Cin ve Sabri Seyis, Ed. Eric J. Topol, Textbook of Cardiovascular Medicine, Çev. Ed. Ömer Kozan, Ankara, Güneş Tıp Kitabevleri, 3. Baskı, 2008, s.227-250.
  • GARTNER. Cornelia, vd.; "The Causes of Prehospital Delay in Myocardial Infarction", Deutsches Arzteblatt International, 2008, 105.15, (Erişim) http://wwww.aerzteblatt.de/pdf/DI/105/15/m286.pdf, 05.09.2013, s.286-291.
  • GERMANN: William J., STAINFIELD. Cindy L.; Principles of Human Physiology, Pearson Benjamin Cummings, 2nd Edition, 2005.
  • GOLDBERG. Robert J., vd.; "Prehospital Delay in Patients with Acute Coronary Syndromes (from The Global Registry of Acute Coronary Events [GRACE])", The American Journal of Cardiology, Vol:103, Issue:5, March, 2009, (Erişim) http://www.sciencedirect.com, 18.08.2013, s.598-603.
  • GOTTLIEB. Shmuel, vd.; "Smoking and Prognosis After Acute Myocardial Infarction in The Thrombolytic Era (Israeli Thrombolytic National Survey)", Journal of the American College of Cardiology, Vol: 28, No: 6, November, 1996,(Erişim) http://www.sciencedirect.com, 31.11.2013, s.1506-1513.
  • İLKAY. Erdoğan, KOZAN. Ömer; "Kararsız Anjina Pektoris ve ST Segment Yükselmesiz Miyokard İnfarktüsü", Ed. Çetin Erol, Klinik Kardiyoloji, Ankara, MN Medikal&Nobel, 2. Baskı, 2011, s.49-61.
  • KANG. Si-Hyuck, ve ark.; "Cigarette Smoking is Paradoxically Associated with Low Mortality Risk After Acute Myocardial Infarction", Nicotine & Tobacco Research, Volume 15, Number 7, July, 2013, (Erişim) http://ntr.oxfordjournals.org/, 18.09.2013, s.1230-1238.
  • KINJO. Kunihiro vd., "Predictors of Length of Hospital Stay After Acute Myocardial Infarction in Japan", Circulation Journal, Vol:68, No:9, 2004, (Erişim) https://www.jstage.jst.go.jp/article/circj/68/9/68_9_809/_article, 15.08.2013, s.809
  • KJEKSHUS. Lars Erik; "Primary Health Care and Hospital Interactions: Effects for Hospital Length of Stay", Scandinavian Journal of Public Health, 2005; 33.2, (Erişim) http://eds.b.ebscohost.com, 25.10.2013, s.114-122.
  • KOTOWYCZ, Mark A., vd.; "Safety and Feasibility of Early Hospital Discharge in ST-Segment Elevation Myocardial Infarction-A Prospective and Randomized Trial in Low-risk Primary Percutaneous Coronary Intervention Patients (The Safe-Depart Trial), American Heart Journal, 2010, Vol:159, Issue:1, (Erişim) http://www.sciencedirect.com, 05.09.2013, s.117. e1-117. e6.
  • KUSHNER. Frederick G., BATES. Eric R.; "ST Segment Elevation Myocardial Infarction", Cardiovascular Therapeutics: A Companion to Braunwald's Heart Disease, Ed. Elliott M. Antman ve Marc S. Sabatine, Elsevier Saunders, 4th Edition, 2013, s.178-213, (Erişim) https://www.clinicalkey.com, 08.09.2013, s.178.213.
  • LANGE. Richard A., HILLIS. L. David; "Acute Coronary Syndrome: Unstable Angina and Non-ST Elevation Myocardial Infarction", Goldman's Cecil Medicine, Ed. Lee Goldman, Andrew I. Schafer, Elsevier Saunders, 24th Edition, 2012, (Erişim) https://www.clinicalkey.com, 08.09.2013, s.425-434.
  • LAVE. Judith R. ve LEINHARDT. Samuel; "The Cost and Length of a Hospital Stay", Inquiry, Vol. 13, No. 4, December, 1976, (Erişim) http://www.jstor.org/stable/29771026, 25.10.2013, s. 327-343.
  • LEE. Thomas H.; "Chest Discomfort", Ed. Joseph Loscalzo, Harrison's Cardiovascular http://online.vitalsource.com/#/books/9780071702911/, 08.09.2013, s.32-36. McGraw-Hill, 2010, (Erişim) LIAPIS. Christos.; "Atherosclerotic
  • Considerations", Rutherford's Vascular Surgery, Ed. Jack L. Cronenwett ve K. Wayne
  • https://www.clinicalkey.com, 10.09.2013, s.394-408. Risk Factors: General Johnston, Saunders Elsevier, 7th Edition, 2010, (Erişim)
  • MOSER. Debra K., vd.; "Reducing Delay in Seeking Treatment by Patients with Acute Coronary Syndrome and Stroke A Scientific Statement from The AMERİCAN Heart Association Council on Cardiovascular Nursing and Stroke https://circ.ahajournals.org/content/114/2/168.full, 05.09.2013, s.168-182. Circulation, 2006, 114.2: OECD (Çevrimiçi),
  • http://stats.oecd.org/index.aspx?queryid=30165 13.08.2013.
  • OECD, Health at a Glance: Europe 2013, OECD Publishing, (Erişim) http://dx.doi.org/10.1787/health_glance-2013-en, 22.12.2013.
  • OZCAN. Yasar A.;Quantitative Methots in Health Care Management, Jossey-Bass, 2nd Edition, 2009.
  • ÖNGEN. Zeki; "Aterosklerozun Patogenezi", Ed. Çetin Erol, Klinik Kardiyoloji, Ankara, MN Medikal&Nobel, 2. Baskı, 2011, s.3-22.
  • ÖNGEN. Zeki, YILMAZ. Yeşim; "Aterosklerozun Patogenezi", Genel Editör: Çetin EROL, İç Hastalıkları, Ankara, MN Medikal&Nobel, Cilt 1, 1. Baskı, 2008, s.2271-2278.
  • PATTERSON. Cam, RUNGE. Marschall S.; "Koroner Ateroskleroz", Marschall S. Runge, E. Magnus Ohman, Netter'in Kardiyolojisi Çev. Ed. Mehmet Sait Buğdacı, Nobel Tıp Kitabevleri, 2008, s.18-28.
  • Resmi Gazete: 13.01.1983 Tarih ve 17927 (1. Mükerrer) Sayılı
  • Resmi Gazete: 25.05.2007 Tarih ve 26532 (Mükerrer) Sayılı.
  • Resmi Gazete: 25.03.2010 Tarih ve 27532 (Mükerrer) Sayılı.
  • RUDD. James H. F., DAVIES. John R., WEISSBERG. Peter L.; "Aterosklerotik Biyoloji ve Hastalığın Epidemiyolojisi", Çev. M. Kemal Erol, Ed. Eric J. Topol, Textbook of Cardiovascular Medicine, Çev. Ed. Ömer Kozan,Ankara, Güneş Tıp Kitabevleri, 3. Baskı, 2008, s.2-12.
  • SACZYNSKI. Jane S., vd.; "Declining Length of Stay for Patients Hospitalized with AMI: Impact on Mortality and Readmissions", The American Journal of Medicine, Vol:123, No:11, November, 2010, (Erişim) http://www.sciencedirect.com, 13.08.2013, s.1007-1015.
  • Sağlık Bakanlığı: T.C. Sağlık Bakanlığı, Sağlık İstatistikleri Yıllığı 2012, Ankara, 2013.
  • SARI, İbrahim, vd. "Factors Associated with Prolonged Prehospital Delay in Patients with Acute Myocardial Infarction", Türk Kardiyoloji Derneği Arşivi, Cilt:36, online.org/dergi/TKDA_36_3_156_162.pdf, 25.12.2013, s.156-162. 2008, (Erişim) http://www.tkd
  • SCHAER. B. A., vd.; "Impact of Contemporary Emergency Percutaneous Coronary Angioplasty for Acute Myocardial Infarction on Length of Hospital Stay", http://www.smw.ch/docs/pdf200x/2007/25/smw-11736.PDF, 05.09.2013, s.363- 367. Weekly, 2007, 137.25/26, (Erişim)
  • www.sggm.saglik.gov.tr, (Çevrimiçi) 25.12.2013.
  • SHEIFER, Stuart E., vd.; "Time to Presentation with Acute Myocardial Infarction in The Elderly Associations with Race, Sex, and Socioeconomic Characteristics" http://circ.ahajournals.org/content/102/14/1651.short, 05. Circulation, 2000, 102.14, (Erişim)
  • SLOT, Madeleine H E Bruins, vd.; "Gender Differences in Pre-hospital Time Delay and Symptom Presentation in Patients Suspected of Acute CORONARY Syndrome in Primary Care", Family practice, 2012, Vol:29, Issue:3, (Erişim) s.332-337. 05.09.2013,
  • SPENCER, Frederick A., vd.; "Declining Length of Hospital Stay for Acute Myocardial Infarction and Postdischarge Outcomes: A Community-Wide Perspective", Archives of Internal Medicine, 164:7, 2004, (Erişim) http://archinte.jamanetwork.com/article.aspx?articleid=216922, 13.08.2013, s.733- 740.
  • The World Bank, 2013: World Development Indicators 2013, The International Bank for Reconstruction and Development/ The World Bank, Washington, D.C., 2013 (Erişim) https://openknowledge.worldbank.org/discover, 20.10.2013. The World Bank, (Çevrimiçi), http://wdronline.worldbank.org/worldbank/a/incomelevel, 23.12.2013.
  • TING. Henry H., vd; " Delay from Symptom Onset to Hospital Presentation for Patients with Non-ST-Segment Elevation Myocardial Infarction", Archives http://archinte.jamanetwork.com/article.aspx?articleid=226179, 05.09.2013 1834- 1841. Medicine, 2010, Vol:170, No:20, (Erişim)
  • TÜİK, 2012: Türkiye İstatistik Kurumu Haber Bülteni, Sayı:13140, Tarih:11.07.2012, (Erişim) www.tuik.gov.tr, 27.10.2013.
  • TÜİK, 2013b: Türkiye İstatistik Kurumu, 2013b, Haber Bülteni, Sayı:15847, Tarih:16 Nisan 2013, (Erişim) www.tuik.gov.tr, 27.10.2013.
  • UNDP,2013: Human Development Report 2013, The Rise of The South: Human Progress in a Diverse World, United Nations Development Programme, 2013, (Erişim) http://hdr.undp.org/en/content/human-development-report-2013, 27.12.2013.
  • URAL. Ertan, KOMSUOĞLU. Baki; "Koroner Kalp Hastalıkları", Klinik Kardiyoloji, Ed. Baki Komsuoğlu, Nobel Tıp Kitapevleri Ltd. Şti., Birinci Basım, 2004, s.511-583.
  • ÜNÜVAR. Necdet, MOLLAHALİLOĞLU. Salih, YARDIM. Nazan, Sağlık Bakanlığı, Refik Saydam Hıfzıssıhhamerkezi Başkanlığı, Hıfzıssıhha Mektebi Müdürlüğü, Türkiye Hastalık Yükü Çalışması 2004, Ankara, 2006, (Erişim) http://ekutuphane.tusak.gov.tr/kitaplar/turkiye_hastalik_yuku_calismasi.pdf, 23.12.
  • VAVALLE, John P., vd.; "Hospital Length of Stay in Patients with Non- ST-Segment Elevation Myocardial Infarction", The American Journal of Medicine, 2012, Vol:125, Issue:11, (Erişim) http://www.sciencedirect.com, 13.11.2013, s.1085-1094.
  • WATERS. David D.; "Risk Factors for Cardiovascular Disease", Ed. Michael H. Crawford vd., Cardiology, Mosby Elsevier, 3rd Edition, 2010, (Erişim) https://www.clinicalkey.com, 11.09.2013, s.27-35.
  • WHITE. Harvey D.; "Anstabil Angina: İskemik Sendromlar", Çev. V. Gökhan Cin ve Sabri Seyis, Ed. Eric J. Topol, Textbook of Cardiovascular Medicine, Çev. Ed. Ömer Kozan, Ankara, Güneş Tıp Kitabevleri, 3. Baskı, 2008, s.251-279.
  • WHO, 2013: World health statistics 2013, World Health Organization 2013, http://www.who.int/gho/publications/world_health_statistics/2013/en, 13.10.2013. (Erişim) WHO, (Çevrimiçi) b, http://www.who.int/mediacentre/factsheets/fs310/en/index2.html, 14.10.2013. WHO, (Çevrimiçi) d, http://www.who.int/mediacentre/factsheets/fs310/en/index3.html, 14.10.2013.
  • WHO, (Çevrimiçi) f, http://www.who.int/trade/glossary/story036/en, 20.10.2013
  • WRIGHT, S. P., vd. "Factors Influencing The Length of Hospital Stay of Patients with Heart Failure" European Journal of Heart Failure, 2003, 5.2, (Erişim) htpp://eurjhf.oxfordjournals.org, 13.08.2013, s.201-209.