Özlem ÖZGÜR GÜNDEŞLİOĞLU2, Emine KOCABAŞ, Zeliha HAYTOĞLU

2012-2017 Yılları Arasında Üniversite Hastanemizde Suçiçeği Nedeni ile Yatış Gerektiren Çocuk Olguların Değerlendirilmesi

Amaç: Rutin aşılama programı uygulanmayan ülkelerde suçiçeği çocukluk çağında yaygın olarak görülür. Bu hastalık özellikle artan yaşla birlikte ciddi mortalite ve morbiditeye yol açabilir. Ülkemizde suçiçeği aşısı 1 Ocak 2013 tarihinde ulusal aşı takvimine alınmıştır. Bu çalışmada suçiçeği aşısının ulusal aşılama programına dahil edilmesinden sonraki dönemde suçiçeği nedeniyle yatırılan çocuk hastaların yatış nedenlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Üçüncü basamak araştırma hastanemizde 1 Ocak 2012 ve 31 Aralık 2017 tarihleri arasında, suçiçeği tanısı ile yatırılan çocuk hastalar geriye dönük olarak incelendi. Hastaların demografik, klinik özellikleri, altta yatan hastalıkları, yatış nedenleri, yatış süreleri, yatış maliyetleri, komplikasyonları ve fatura bilgileri geriye dönük olarak incelendi. Bulgular: Çalışma süresince 66’sı erkek (%63.5), 38’i kız (% 36.5) toplam 104 hasta incelenmiştir. Olguların 40‘ı (%38.4) 24 ay ve altında, 36’sı (%34.6) 25 – 72 ay arasında, 28’i (%27) 73 ay ve üzerindeydi. 45 olguda (%43.3) altta yatan hastalık yoktu. 21 olgu (%20.2) pnömoni, 21 olgu (%20.2) sekonder bakteriyel cilt enfeksiyonu, 7 olgu (%6.7) serebellit, 6 olgu (%5.8) yaygın cilt döküntüsü, 4 olgu (%3.8) hepatit, 4 olgu (%3.8) febril konvülziyon, 3 olgu(%2.9) menigoensefalit, 3 olgu(%2.9) kanamaya yol açan trombositopeni, 1(%1) olgu bronşiolit nedeniyle yatırılmştı. Tüm yatışların 25’i (%24) 2012 yılında iken, 11’i (%10.6) 2016 yılında, 6’sı (%5.8) ise 2017 yılındaydı. Altta yatan hastalığı olmayan 45 olgunun yatış maliyetinin ortanca değeri, altta yatan hastalığı olan 59 olguyla kıyaslandığında ortanca değerleri arasında istatistiksel fark saptanmadı. Altta yatan hastalığı olmayan olgularda yatış süresinin ortanca değeri 7 (3-42) gündü. Sonuç: Bulgularımız suçiçeğinin günümüzde kronik hastalığı olmayan sağlıklı çocuklarda bile ciddi sorunlar oluşturabildiğini göstermiştir. Suçiçeği aşısının ulusal aşılama programına alınmasından sonra, yıllar içinde yatış gerektiren olguların sıklığında anlamlı düzeyde azalma olduğu gözlenmiştir.

Anahtar Kelimeler:

Komplikasyon, Suçiçeği, Suçiçeği aşısı

Evaluation of Hospitalizations among Children with Varicella Between 2012 and 2017 at an University Hospital

Objective: Varicella is common in childhood in countries where a routine vaccination program is not implemented. The disease can cause serious morbidity and even mortality, especially with increasing age. In our country, the varicella vaccine was included in the national vaccination program on 1 January 2013. The aim of this study was to investigate the hospitalized children with varicella after the administration of varicella vaccine in the national vaccination program. Material and Methods: Pediatric patients who were admitted to our tertiary research hospital between January 1, 2012 and December 31, 2017 with a diagnosis of varicella were evaluated retrospectively. The patient demographics, clinical characteristics, underlying diseases, duration of hospitalization, hospitalization costs, and complications were analyzed. Results: A total of 104 cases consisting of 66 (63.5%) males and 38 (36.5%) females were included. Of these cases, 40 (38.4%) were aged under 24 months, 36 (34.6%) between 25 and 72 months, and 28 (27%) over 73 months. There were no underlying diseases in 45 (43.3%) cases. The causes of admission were pulmonary infection in 21 (20.2% ) cases, bacterial skin superinfections in 21 (20.2%) cases, cerebellitis in 7 (6.7%) cases, disseminated rash in 6 (5.8%) cases, hepatitis in 4 (3.8%) cases, febrile convulsions in 4 (3.8%) cases, severe thrombocytopenia in 3 (2.9%) cases, meningoencephalitis in 3 (2.9%) cases, and bronchiolitis in 1(1%) case of all admissions, 24% were in 2012, 10.6% in 2016, and 5.8% in 2017. The median hospital cost per hospital stay was not different in patients without an underlying disease compared to patients with an underlying disease. The median duration of hospitalization was 7 (3-42) days in patients without an underlying disease. Conclusion: These findings indicate that chickenpox can cause a serious problem even in healthy children without underlying diseases. Following the inclusion of varicella vaccine in the national vaccination program, a critical decrease was observed in the frequency of cases requiring hospitalization.

Keywords:

Complication, Varicella, Vaccination,

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