Buket KARA, Gülsüm ALKAN, Kübra ERTAN, Melike EMİROĞLU, Prof. Dr. Uğur ARSLAN, Hüsamettin VATANSEV, Yavuz KÖKSAL

Çocukluk çağı febril nötropenisinde solunum virüsü panelinin maliyet etkinliği

Amaç: Bu çalışmanın amacı, kemoterapi alan çocuklarda febril nötropeni (FN) atağında respiratuar virüs panel testinin klinik faydasını ve maliyetini analiz etmektir. Gereç ve Yöntem: 2014-2018 yılları arasında kanserli 93 çocukta 180 FN epizodu retrospektif olarak analiz edildi. Hastalar solunum virüsü paneli olanlar (Grup A) ve olmayanlar (Grup B) olarak ikiye ayrıldı. Grup A ve B’nin demografik ve klinik özellikleri ile maliyet analizleri not edildi. Bulgular: Febril nötropeni ataklarının 46'sı Grup A'da (%25,5) ve 134'ü Grup B'de (%74,5) idi. Grup A’da yer alan 46 epizodun 45’inde (%97,8) pozitifilik saptadık. Grup A'da 14 FN atağında (%30,4) modifikasyon gerekirken, B grubunda 35 FN atağında (%26,1) modifikasyon gerekti. Aradaki fark istatistiksel olarak anlamlı değildi (p=0,570). Grup A'daki 46 FN atağından sadece 5’inde (%10,8) solunum virüsü paneline göre modifiye edildi. Solunum virüsü paneli fiyatları 72,43$ (çeyrekler arası aralık, 38,8). Medyan solunum virüsü paneli maliyetinin toplam maliyete oranı %9,67'dir (çeyrekler arası aralık 11,6). Grup A'nın medyan toplam maliyeti 663,18$ (çeyrekler arası aralık, 850,1), B grubunun maliyeti ise 596,24$ (çeyrekler arası aralık, 723,81). Fark istatistiksel olarak anlamlı değildi (p=0.141). Sonuç: Solunum yolu paneli FN ataklarında hızlı sonuç vererek antibiyotik tercihine katkı sağlayabilir. Bununla birlikte, modifikasyon oranları üzerinde herhangi bir etki gözlenmedi ve hastaların sadece küçük bir yüzdesine solunum yolu paneline göre antibiyotik modifikasyonu uygulandı.

Anahtar Kelimeler:

Febrile neutropenia, respiratory virus panel, children

The cost effectiveness of the respiratory virus panel in childhood febrile neutropenia

ABSTRACT Objective: The aim of this study is to analyze the clinical utility and cost of the respiratory virus panel test in the febrile neutropenia (FN) episode in children undergoing chemotherapy. Material and Method: From 2014 to 2018, 180 episodes of FN in 93 children with cancer were retrospectively analyzed. The patients were divided into those with (Group A) and without respiratory virus panel (Group B). The demographic and clinical features and cost analysis of the groups A and B were noted. Results: Of these FN episodes, 46 were in Group A (25.5%) and 134 were in Group B (74.5%). We found positivity in 45 (97.8%) of 46 episodes in Group A. While modification was required in 14 FN episodes (30.4%) in Group A, modification was required in 35 FN episodes (26.1%) in group B. The difference was not statistically significant (p=0.570). In Group A, only 5 (10.8%) were modified according to the respiratory virus panel. The respiratory virus panel prices were $72.43 (interquartile range, $38.8). The ratio of respiratory virus panel cost to the total cost was 9.67% (interquartile range 11.6). The median total cost of group A was $663.18 (interquartile range, 850.1), while that of group B was $596.24 (interquartile range, 723.81). The difference was not statistically significant (p=0.141). Conclusion: The respiratory virus panel may contribute to the preference of antibiotics by giving rapid results in FN attacks. However, no effect on modification rates was observed, and only a small percentage of patients underwent antibiotic modification according to respiratory virus panel.

Keywords:

Febrile neutropenia, respiratory virus panel, children,

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