Kesici delici aletlerle meydana gelen yaralanma olgularının değerlendirilmesi
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Adli tıp uygulamalarında kesici-delici aletlere bağlı yaralanma ve ölümler sıklıkla karşımıza çıkmaktadır. Bunların azaltılabilmesi ve gerekli önlemlerin alınabilmesi için epidemiyolojik ve demografik incelemelerin yapılması, travma özelliklerinin ortaya konması gerekmektedir. Çalışmamızda olguların yaş, cinsiyet, yaralanma özellikleri, MAIS ve ISS skorlarının belirlenmesi, olguların raporlarının TCK'nın yaralanma ile ilgili maddelerinde tanımlanan kriterler yönünden araştırılması, bu kriterlerin uluslararası AIS, ISS travma skorlama sistemleri ile karşılaştırılması ve bu skor sistemlerinin adli rapor düzenlemede kullanılabilirliklerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Anabilim Dalımızca 01.01.2012-31.12.2018 tarihleri arasında rapor düzenlenen tüm olgular retrospektif olarak incelenerek, KDAY nedeniyle başvuran 277 olgu çalışmamıza dahil edilmiştir. Bulgular: Olguların; ortalama yaşının 29.53 olduğu, %47.3'ünün (n=131) 18-30 yaş arasında olduğu, %91.7'sinin (n=254) erkek olduğu, en sık yaz mevsiminde meydana geldiği, %49.8'inin (n=138) çeşitli bölümlere yatırılarak tedavi edildiği tespit edildi. En fazla yaralanan vücut bölgesinin %36.6 (n=133) ile ekstremiteler olduğu, en fazla yaralanan iç organların %3 (n=12) ile kalın bağırsak, %2.7 (n=11) ile ince bağırsak olduğu bulundu. Olguların %36.5'inin (n=101) hayati tehlikeye maruz kaldığı, %60.3'ünün (n=167) basit tıbbi müdahale ile giderilebilecek nitelikte olmadığı belirlendi. Hayati tehlike varlığını değerlendirme açısından kesme değerleri AIS sisteminde 1.5 olarak, ISS sisteminde 3.5 olarak bulundu. Sonuç: Hastaların yarısında hastane yatışı ihtiyacı olması, %40'a yakınında hayati tehlike arz edecek yaralanmalar ortaya çıkması bu alet yaralanmalarının ciddiyetini ortaya koymakta ve yasal önlemler alınması gerektiğini göstermektedir. Bunun yanında MAIS, ISS değerleri hayati tehlikesi bulunan birçok olguda düşük hesaplanmış olup kullanılan cetveller arasında ciddi farklılıklar olduğu görülmüştür. Dolayısıyla bu skorlama sistemlerinin mevcut halleriyle, penetran yaralanmalı hastaların adli raporlarının standardize olarak düzenlenmesinde kullanılması olası görünmemektedir.
Introduction: In forensic medicine practice, injuries and deaths due to stab wounds are frequently encountered. Epidemiological and demographic investigations and trauma characteristics should be demonstrated in order to reduce the injuries and deaths related to these instruments and to take the necessary precautions. Material and method: All of the cases that were reported by our department between 01.01.2012-31.12.2018 were examined retrospectively and 277 cases who applied for stab injury were included in our study. The aim of this study was to determine the age, sex, injury characteristics, MAIS, ISS scores of the cases, to investigate the forensic reports of the cases in terms of the criteria defined in the Turkish Penal Code, to compare these criteria with the international AIS, ISS trauma scoring systems and to investigate the usability of these scoring systems in forensic reports. Results: The mean age was 29.53, 47.3% (n=131) of the cases were between the ages of 18-30, 91.7% (n=254) were male. The most frequent injuries were found to be 27.1% (n=75) in summer. 49.8% (n=138) of patients were hospitalized in various departments. The most commonly injured body region was extremities with 36.6% (n=133) ratio. The most frequently injured internal organs were large intestine with 3% (n=12), small intestine 2.7% (n=11). It was determined that 36.5% (n=101) of the cases were life-threatening and 60.3% (n=167) of cases was cannot be cured by a simple medical treatment. The cut-off values were calculated to be 1.5 in the AIS system and 3.5 in the ISS system to assess the presence of life-threatening injuries. Conclusion: The need for hospitalization in half of the patients and the occurrence of life-threatening injuries in the vicinity of 40% indicates the seriousness of these injuries and indicates that legal measures should be taken. In addition, MAIS, ISS values were calculated to be low in many life-threatening cases and significant differences were found between the scales used. Therefore, it does not seem possible to standardize forensic reports of patients with penetrating injuries using the current AIS and ISS trauma scores. VIII Keyword: stab wound, abbreviated injury scale, injury severity score.
Introduction: In forensic medicine practice, injuries and deaths due to stab wounds are frequently encountered. Epidemiological and demographic investigations and trauma characteristics should be demonstrated in order to reduce the injuries and deaths related to these instruments and to take the necessary precautions. Material and method: All of the cases that were reported by our department between 01.01.2012-31.12.2018 were examined retrospectively and 277 cases who applied for stab injury were included in our study. The aim of this study was to determine the age, sex, injury characteristics, MAIS, ISS scores of the cases, to investigate the forensic reports of the cases in terms of the criteria defined in the Turkish Penal Code, to compare these criteria with the international AIS, ISS trauma scoring systems and to investigate the usability of these scoring systems in forensic reports. Results: The mean age was 29.53, 47.3% (n=131) of the cases were between the ages of 18-30, 91.7% (n=254) were male. The most frequent injuries were found to be 27.1% (n=75) in summer. 49.8% (n=138) of patients were hospitalized in various departments. The most commonly injured body region was extremities with 36.6% (n=133) ratio. The most frequently injured internal organs were large intestine with 3% (n=12), small intestine 2.7% (n=11). It was determined that 36.5% (n=101) of the cases were life-threatening and 60.3% (n=167) of cases was cannot be cured by a simple medical treatment. The cut-off values were calculated to be 1.5 in the AIS system and 3.5 in the ISS system to assess the presence of life-threatening injuries. Conclusion: The need for hospitalization in half of the patients and the occurrence of life-threatening injuries in the vicinity of 40% indicates the seriousness of these injuries and indicates that legal measures should be taken. In addition, MAIS, ISS values were calculated to be low in many life-threatening cases and significant differences were found between the scales used. Therefore, it does not seem possible to standardize forensic reports of patients with penetrating injuries using the current AIS and ISS trauma scores. VIII Keyword: stab wound, abbreviated injury scale, injury severity score.
Açıklama
Anahtar Kelimeler
Adli Tıp, Forensic Medicine, kesici-delici alet, abbreviated injury scale, injury severity score, stab wound, abbreviated injury scale, injury severity score.
