Penetran yaralanmaya bağlı ölüm olgularında anatomik travma skorlarının değerlendirilmesi
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Dosyalar
Tarih
2019
Yazarlar
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
GiriĢ ve Amaç: Penetran travma olgularına, gerek acil gerekse cerrahi kliniklerinin yanı sıra Adli Tıp pratiğinde de sıklıkla karĢılaĢılmaktadır. ÇalıĢmamızda penetran yaralanmaya bağlı ölüm olgularının epidemiyolojik özellikleri incelenerek ülkemiz travma verilerine katkı sağlanması ve anatomik travma skorları değerlendirilerek önlenebilir nitelikteki ölüm olgularının tartıĢılması amaçlanmıĢtır. Yöntem: 2012-2018 yılları arasında Hatay Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Adli Tıp Anabilim Dalı'nda yapılan otopsilerin raporları retrospektif olarak incelenmiĢ, penetran yaralanma sonucu ölen 271 olgu çalıĢmaya dahil edilmiĢtir. Olguların demografik özellikleri, yaralanma özellikleri ve travma skorları incelenerek önlenebilir nitelikteki ölümler ayrıca değerlendirilmiĢtir. Bulgular: YaĢ ortalaması 30.37 olup erkek/kadın oranı 8 bulundu. Olguların %94.8'inde (n=257) ateĢli silah yaralanması mevcuttu. Olgularda sıklıkla tek vücut bölgesinde (%64.5, n=175) yaralanma meydana geldiği, en sık izole baĢ-boyun yaralanması (%39.1, n=106) olduğu görüldü. Olguların %38.7'sinde NISS (New Injury Severity Score) puanları ISS (Injury Severity Score) puanlarından yüksek bulundu. Yaralanmadan sonraki ilk 24 saat içinde ölen vakaların %54.3'ünde baĢboyun bölgesinde yaralanma olup skorun 25-75 puan aralığında olduğu (p<0.001) görüldü. Önlenebilir ölüm olarak değerlendirilen, NISS puanı 0-24 olan 58 (%21.4) olgunun %94.8'inde (n=55) toraks, batın veya ekstremite bölgelerinde yaralanma bulunduğu saptandı. Sonuç: Travmaya hastaların hızlı bir değerlendirme süreci sonrasında yeterli süre ve kalitede tedavi almaları amacıyla sağlık alanında gerekli düzenlemelerin yapılması ve travma hastalarının yoğun olduğu bölgelerde kapsamlı travma merkezlerinin kurulması yaralanmaya bağlı ölüm oranlarının azalmasında faydalı olacaktır.
Background and Aim: Penetrating trauma cases are common in both emergency, surgical clinics and forensic medicine practice. In this study, we aimed to contribute to our country's trauma data by evaluating the epidemiological characteristics of penetrating injury and to investigate preventable deaths by evaluating anatomic trauma scores. Method: We retrospectively reviewed the reports of autopsies performed between 2012-2018 at the Hatay Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Forensic Medicine Department and evaluated 271 cases who died as a result of penetrating injury. We evaluated the demographic characteristics, injury characteristics and trauma scores of the cases and investigated the preventable deaths. Results: The mean age was 30.37 and male/female ratio was 8. Gunshot wounds were present in 94.8% (n = 257) of all cases. We found that 64.5% (n=175) of cases had injured from single body region and 39.1% (n=106) had isolated had-neck injury. NISS was higher than ISS in 38.7% of all cases. We found that 54.3% of the cases who died within the first 24 hours after trauma, had head-neck injury and NISS was between 25-75 points (p <0.001). Of the 58 (21.4%) cases with NISS score 0-24, which were evaluated as preventable death, 94.8% (n = 55) had injuries in thorax or abdomen region or extremities. Conclusion: Making the necessary arrangements in health institutions in order to ensure that trauma patients receive effective treatment and providing comprehensive trauma centers in regions with high trauma rates will be beneficial in reducing the mortality rates due to injury.
Background and Aim: Penetrating trauma cases are common in both emergency, surgical clinics and forensic medicine practice. In this study, we aimed to contribute to our country's trauma data by evaluating the epidemiological characteristics of penetrating injury and to investigate preventable deaths by evaluating anatomic trauma scores. Method: We retrospectively reviewed the reports of autopsies performed between 2012-2018 at the Hatay Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Forensic Medicine Department and evaluated 271 cases who died as a result of penetrating injury. We evaluated the demographic characteristics, injury characteristics and trauma scores of the cases and investigated the preventable deaths. Results: The mean age was 30.37 and male/female ratio was 8. Gunshot wounds were present in 94.8% (n = 257) of all cases. We found that 64.5% (n=175) of cases had injured from single body region and 39.1% (n=106) had isolated had-neck injury. NISS was higher than ISS in 38.7% of all cases. We found that 54.3% of the cases who died within the first 24 hours after trauma, had head-neck injury and NISS was between 25-75 points (p <0.001). Of the 58 (21.4%) cases with NISS score 0-24, which were evaluated as preventable death, 94.8% (n = 55) had injuries in thorax or abdomen region or extremities. Conclusion: Making the necessary arrangements in health institutions in order to ensure that trauma patients receive effective treatment and providing comprehensive trauma centers in regions with high trauma rates will be beneficial in reducing the mortality rates due to injury.
Açıklama
Anahtar Kelimeler
Adli Tıp, Forensic Medicine, Hatay, otopsi, penetran travma, travma skoru, NISS, Hatay, autopsy, penetrating injury, trauma score, NISS
