Background: Chronic obstructive pulmonary disease (COPD) is a disease of increasing significance in terms of economic and social burden due to its increasing prevalence and high costs. Direct costs of COPD are mostly associated with hospitalization expenditures. In this study, our objective was to investigate the costs of hospitalization and factors affecting these costs in patients hospitalized due to acute exacerbation of COPD (AECOPD).Methods: A total of 284 patients hospitalized AECOPD were included in the study. Data were examined retrospectively using the electronic hospital charts.Results: Mean duration of hospitalization was 11.38 ± 6.94 days among study patients. Rates of admission to the intensive care unit, initiation of non-invasive mechanical ventilation (NIMV) and invasive mechanical ventilation (MIV) were 37.3% (n=106), 44.4% (n=126) and 18.3% (n=52) respectively. The rate of mortality was 14.8% (n=42). Mean cost of a single patient hospitalized for an AECOPD was calculated as $1765 ± 2139. Mean cost of admission was $889 ± 533 in standard ward, and $2508 ± 2857 in intensive care unit (ICU). The duration of hospitalization, a FEV1% predicted value below 30%, having smoked 40 package-years or more, the number of co-morbidities, NIMV, IMV, ICU, exitus and the number of hospitalizations in the past year were among the factors that increased costs significantly. Hospital acquired pneumonia, chronic renal failure and anemia also increased the costs of COPD significantly.Conclusion: The costs of treatment increase with the severity of COPD or with progression to a higher stage. Efforts and expenditures aimed at preventing COPD exacerbations might decrease the costs in COPD.

Objective: Sleep disorders are important public health issues that decrease the individuals' quality of life by affecting their productivity and performance in a negative way. The frequency of sleep disorders among people who work shifts with irregular sleep patterns is apparent. For healthcare providers, most of whom work shifts, the available data related to obstructive sleep apnea syndrome (OSAS) are insufficient. Also, this is the first study that has been conducted using an all-night polysomnography (PSG) for health staff in our country. In our study, we aimed to investigate the prevalence of snoring and OSAS among the nurses and resident doctors working at our hospital.Methods: Face-to-face interviews were performed with all nurses and resident doctors who worked at our hospital and agreed to participate in our study. All-night PSG examination was recommended to participants with concurrent witnessed apnea and/or excessive daytime sleepiness (EDS) with snoring. The frequency of OSAS was evaluated in cases exposed to polysomnography, and those with and without OSAS were compared in terms of shift rates. Results:The study included 257 participants. Of these, 63% were nurses and 37% were resident doctors; overall, 34.2% of the cases were male. The mean age was 28. 8±3.7 (19-39) years and the mean body mass index was 24.03±3.85 kg/m 2 . Among the participants, the mean number of monthly night shifts was 7.6±3.8. Also, 28.8% of the participants (n=74) experienced snoring, 2.7% (n=7) had witnessed apnea, and 7.8% (n=20) had EDS (Epworth sleepiness scale≥11). Four (1.6%) of the 20 participants who were proposed to undergo PSG refused this examination. Sixteen cases were exposed to PSG (6.2%). According to the PSG results, the prevalence of OSAS was 4.7% among all healthcare providers and 5.1% among the health staff working shifts. Of the cases with OSAS, 91.7% (11/12) were working shifts while 83.3% (204/245) of those without OSAS were working shifts (p=0.697). All of the cases diagnosed with OSAS were male, but 31% of the cases without OSAS were male (p<0.001). Conclusion:For those healthcare providers who are engaged in duties requiring significant amounts of attention and concentration, the symptoms related to sleep disorders should be questioned and diagnostic evaluation and treatment should be performed for suspected cases.Keywords: Health care providers, OSAS, sleep disorders, shift work INTRODUCTIONObstructive Sleep Apnea Syndrome (OSAS) is characterised by the episodes of complete or partial upper respiratory airway obstruction recurring during sleep and often a reduction in blood oxygen saturation (1). The gold standard diagnostic method for this syndrome is polysomnography (PSG).Although PSG is the final diagnostic method for OSAS, most OSAS prevalence studies have been conducted based on symptoms rather than PSG results. However, there are some studies in which symptoms and PSG test results have been evaluated together in order to estimate the prevalence of OSAS. In a widespread prevalence stu...