Browsing by Author "Kilic, Mehmet"

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Cost Analysis on Intensive Care Unit Costs Based on the Length of Stay
(Aves, 2019) Kilic, Mehmet; Yuzkat, Nureddin; Soyalp, Celaleddin; Gulhas, Nurcin
Objective: The present study aimed to determine the profit/loss ratio and the service casts in intensive care unit (ICU) based on the length of ICU stay. Methods: This retrospective study reviewed the medical records of 458 patients who were admitted to ICU between August 2016 and August 2017. Depending on the length of their ICU stay, the patients were divided into six groups: (I) 1 day, (II) 2 days, (III)3 days, (IV) 4 days, (V) 5 days and (VI) more than 5 days. These charges were evaluated under six categories: surgery, laboratory tests, drugs, tools and equipment, radiographic workup and others. Results: This study reviewed the medical records of patients including 273 (59.6%) men and 185 (40.4%) women. The mean age of the patients was 53.87 +/- 22.6 years. The profit/loss ratio was in favour of loss in group I (12,870.82 TL), group II (9,384.61 TL) and group III (371.18 TL). The ration was in favour of profit in group IV (16,505.4 TL). Total service costs comprised 38.31% drug costs, 24.45% tools/equipment, 13.14%, laboratory tests, 10% other costs, 4.92% surgical costs and 3.1% radiographic tests. Conclusion: The cost analysis based on the service costs in ICU with regards to the length of ICU stay revealed that due to the greater use of diagnostic, surgical and medical tools and equipment and laboratory and radiographic tests, the profit/loss ratio was in favour of loss within the first three days in ICU. This ratio turned to profit beginning from day 4 in ICU due to the decrease in the use of these equipment and tests. Moreover total ICU costs comprised 38.51% drug costs and 24.45% medical tools and equipment.
Determining University Students' Cognitive Structures and Alternative Concepts on Striated Muscle by Word Association Test
(Iermakov S S, 2022) Akatan, Abdulkadir; Kilic, Mehmet; Basturk, Zeliha; Embiyaoglu, Nuri M.
Background and Study Aim Muscles are a set of topics for physical education and sports. Cognitive structure and alternative concepts of students should be diagnosed about striated muscles, which are very rich in terms of abstract concepts. The aim of this research is to determine the cognitive structures, alternative concepts and conceptual change process of university students on striated muscle with the word association test. Material and Methods 50 students who took physiology course in Selcuk University physical education and sports teaching 2nd year participated in the research. The research was designed with a single group pretest posttest weak experimental design. The students were given a pre-test Word Association Test (WAT), then the subject of striated muscles in the training information curriculum was explained, and then WAT was re-applied as a post-test. As a result of the tests applied, the frequencies of the answer words given by the students to 11 key concepts were calculated and the cut-off points were determined and concept networks were created. In addition, the sentences formed by the students about these concepts were examined in terms of misconceptions. Results We found that the students produced 44 answer words in the pre-test and 64 in the post-test, and the frequency of many concepts increased in the post-test compared to the pre-test. However, an increase in the knowledge level and concept associations of the students at the desired level was not observed. In addition, we determined that although the students' misconceptions about striated muscle decreased in the post-test compared to the pre-test, they still continued, and the students generally had unscientific or superficial knowledge in both tests. Conclusions As a result of the research, it was determined that there was a significant change in the cognitive structure of the students about the skeletal muscle, although it was not at a sufficient level, and their misconceptions were reduced. It has been concluded that the WAT is an important alternative assessment tool to determine the conceptual development in preliminary and post-knowledge, as well as a strategy that can be used to ensure meaningful learning and conceptual change.
Evaluation of the Incidence, Characteristics, and Outcomes of Pediatric Chronic Critical Illness
(Public Library Science, 2021) Demirkiran, Hilmi; Kilic, Mehmet; Tomak, Yakup; Dalkiran, Tahir; Yurttutan, Sadik; Basaranoglu, Murat; Oksuz, Hafize
Our aim was to determine characteristics of children with chronic critical illness (CCI) admitted to the pediatric intensive care unit (PICU) of a tertiary care children's hospital in Turkey. The current study was a multicenter retrospective cohort study that was done from 2014 to 2017. It involved three university hospitals PICUs in which multiple criteria were set to identify pediatric CCIs. Pediatric patients staying in the ICU for at least 14 days and having at least one additional criterion, including prolonged mechanical ventilation, tracheostomy, sepsis, severe wound (burn) or trauma, encephalopathy, traumatic brain injury, status epilepticus, being postoperative, and neuromuscular disease, was accepted as CCI. In order to identify the newborn as a chronic critical patient, a stay in the intensive care unit for at least 30 days in addition to prematurity was required. Eight hundred eighty seven (11.14%) of the patients who were admitted to the PICU met the definition of CCI and 775 of them (87.3%) were discharged to their home. Of CCI patients, 289 (32.6%) were premature and 678 (76.4%) had prolonged mechanical ventilation. The total cost values for 2017 were statistically higher than the other years. As the length of ICU stay increased, the costs also increased. Interestingly, high incidence rates were observed for PCCI in our hospitals and these patients occupied 38.01% of the intensive care bed capacity. In conclusion, we observed that prematurity and prolonged mechanical ventilation increase the length of ICU stay, which also increased the costs. More work is needed to better understand PCCI.
Operative and Prognostic Parameters Associated With Elective Versus Emergency Surgery in a Retrospective Cohort of Elderly Patients
(Springer, 2019) Soyalp, Celaleddin; Yuzkat, Nureddin; Kilic, Mehmet; Akyol, Mehmet Edip; Demir, Canser Yilmaz; Gulhas, Nurcin
AimTo evaluate operative and prognostic parameters associated with elective versus emergency surgery in a retrospective cohort of elderly patients.MethodsA total of 533 geriatric patients (aged65 years, median age: 73.0 years, 50.7% were females) who underwent either elective surgery (n=285) or emergency surgery (n=248) were included in this study. Data on patient demographics, co-morbid disorders, type of surgery and anesthesia, American Society of Anesthesiologists (ASA) physical status (PS) classification, length of hospital stay, length of ICU stay, hospitalization outcome, prognosis (survivor, non-survivor) were obtained from medical records.ResultsEmergency surgery group was associated with higher prevalence of ASA-PS III (48.8 vs. 25.6%, p<0.001) and ASA-PS IV (19.0 vs. 0.4%, p<0.001) categories and higher mortality rates (20.6 vs. 4.9% vs. p<0.001) when compared to the elective surgery group. ASA-PS IV category was associated with oldest patient age (median 82.0 vs. 71.0years for ASA-PS I and II, p<0.001 for each and versus 75.0years for ASA-PS III, p<0.05) and highest mortality rate (35.4 vs. 3.4% for ASA-PS I, 6.0% for ASA-PS II and 16.5% for ASA-PS III, p<0.001) as compared with other categories.ConclusionIn conclusion, our findings in a retrospective cohort of elderly surgical patients revealed high prevalence of co-morbidities, predominance of ASA-PS II or ASA-PS III classes and an overall in-hospital mortality rate of 12.2%. Emergency as compared with elective surgery seems to be associated with older age, male gender, ASA-PS III and IV classes, higher likelihood of postoperative ICU transfer and higher mortality rates.