Çoklu travma hastalarında travma skorlarının (RTS, GAP, EMTRAS) klinik değerliliğinin incelenmesi, acil servis mortalite ile korelasyonu ve literatür ile karşılaştırılması
Yükleniyor...
Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Acil servislere başvuran hasta sayısının artması, gerçekten acil olan hastaların seçimini zorlaştırmaktadır. Bu nedenle, çeşitli travma ciddiyet skorlama sistemleri geliştirilmiş ve uygulanması önerilmiştir. Bu çalışmada, çoklu travma hastalarında, travma ciddiyet skorlarının (RTS, GAP, EMTRAS) mortalite ile ilişkileri değerlendirilmiştir. Gereç ve yöntem: Bu çalışma Hatay Mustafa Kemal Üniversitesi Hastanesi Acil servisinde bir yıllık dönemde, acil servise başvuran hastaların elektronik verileri restrospektif olarak değerlendirilerek yapıldı. Çalışmaya 16 yaş üzeri, çoklu travması olan hastalar dahil edilmiştir. Hastaların demografik verileri, skor hesaplamasında kullanılacak verileri ve Glasgow Koma Skorları hasta dosyalarından tarandı. Acil servis içindeki ve kısa dönem içindeki (30gün) mortaliteleri, travma skorları ile değerlendirildi. Veriler SPSS. version 21'e kaydedilerek analiz edildi Bulgular: Çalışmaya 333 çoklu travma hastası dahil edildi. Hastaların 294'ü (%88,3) erkek, 39'u (%11,7) kadındı. Medyan yaş 35,76±17,16 (Min:16-Max:90) olarak bulundu. Mevcut veriler ile hastaların RTS, GAP ve EMTRAS skorları hesaplandı. ROC eğrileri çizilip klinik değerlilikleri hesaplanan travma skorlarından RTS ve EMTRAS 'in acil servis içindeki mortaliteyi göstermede en başarılı skorlar olduğu görüldü. EAA'lar (eğri altında kalan alanlar) RTS, GAP, EMTRAS için sırası ile 0,901 ± 0,024 [%95 GA, 0,854 ila 0,948], 0,876 ± 0,035 [%95 GA, 0,808 ila 0,945], 0,917 ± 0,018 [%95 GA, 0,882 ila 0,953] olarak bulundu. Baz defisiti, PTZ ve INR parametreleri ile kısa dönem mortalite ve acil servis mortalite oranı arasında güçlü bir ilişki olduğu görüldü(p<0.001 GA, 0,848 ila 0,953). P<0,05 anlamlı olarak değerlendirildi. Sonuç: EMTRAS ve RTS skorlama sistemlerinin acil servislerde kullanılması sonrası ciddi travmaların etkin ve hızlı bir şekilde tanınması sağlanabilir. Bu hastaların triaj sonrası tedavileri başlanıp uygun merkezlere sevki sağlanarak mortalite ve morbidite oranlarının azalacağı kanaatindeyiz.
Aim: The increase in the number of patients presenting to emergency services makes it difficult to choose patients who are really urgent. Therefore, various trauma severity scoring systems have been developed and proposed to be implemented. In this study, the relationship between trauma severity scores (RTS, GAP, EMTRAS) and mortality in multiple trauma patients was evaluated. Materials and Methods: This study was performed retrospectively by evaluating the electronic data of the patients who applied to the emergency department in Hatay Mustafa Kemal University Hospital Emergency Department for one year period. Patients with multiple trauma over 16 years of age were included in the study. The demographic data of the patients, the data to be used in the calculation of scores and Glasgow Coma Scores were scanned from the patient files. Mortality in the emergency department and in the short term (30 days) was evaluated by trauma scores. Data were analyzed by saving to version 21 SPSS. Results: 333 multiple trauma patients were included in the study. Of the patients, 294 (88.3%) were male and 39 (11.7%) were female. The median age was found to be 35.76 ± 17.16 (Min: 16-Max: 90). RTS, GAP and EMTRAS scores of the patients were calculated with the available data. ROC curves were drawn and clinical valorities were calculated from the trauma scores of RTS and EMTRAS were the most successful scores in predicting mortality in the emergency department. EAAs (areas under the curve) were found for RTS, GAP, EMTRAS, 0,901 ± 0,024 [%95 GA, 0,854 ila 0,948], 0,876 ± 0,035 [%95 GA, 0,808 ila 0,945], 0,917 ± 0,018 [%95 GA, 0,882 ila 0,953] respectively. There was a strong correlation between baseline deficit, PTZ and INR parameters and short-term mortality and emergency room mortality(p<0.001 GA, 0,848 ila 0,953). P <0.05 was considered significant. Conclusion: After the use of EMTRAS and RTS scoring systems in emergency departments, effective and rapid diagnosis of severe traumas can be achieved. We believe that the mortality and morbidity rates of these patients will be reduced after triage treatment and referral to appropriate centers.
Aim: The increase in the number of patients presenting to emergency services makes it difficult to choose patients who are really urgent. Therefore, various trauma severity scoring systems have been developed and proposed to be implemented. In this study, the relationship between trauma severity scores (RTS, GAP, EMTRAS) and mortality in multiple trauma patients was evaluated. Materials and Methods: This study was performed retrospectively by evaluating the electronic data of the patients who applied to the emergency department in Hatay Mustafa Kemal University Hospital Emergency Department for one year period. Patients with multiple trauma over 16 years of age were included in the study. The demographic data of the patients, the data to be used in the calculation of scores and Glasgow Coma Scores were scanned from the patient files. Mortality in the emergency department and in the short term (30 days) was evaluated by trauma scores. Data were analyzed by saving to version 21 SPSS. Results: 333 multiple trauma patients were included in the study. Of the patients, 294 (88.3%) were male and 39 (11.7%) were female. The median age was found to be 35.76 ± 17.16 (Min: 16-Max: 90). RTS, GAP and EMTRAS scores of the patients were calculated with the available data. ROC curves were drawn and clinical valorities were calculated from the trauma scores of RTS and EMTRAS were the most successful scores in predicting mortality in the emergency department. EAAs (areas under the curve) were found for RTS, GAP, EMTRAS, 0,901 ± 0,024 [%95 GA, 0,854 ila 0,948], 0,876 ± 0,035 [%95 GA, 0,808 ila 0,945], 0,917 ± 0,018 [%95 GA, 0,882 ila 0,953] respectively. There was a strong correlation between baseline deficit, PTZ and INR parameters and short-term mortality and emergency room mortality(p<0.001 GA, 0,848 ila 0,953). P <0.05 was considered significant. Conclusion: After the use of EMTRAS and RTS scoring systems in emergency departments, effective and rapid diagnosis of severe traumas can be achieved. We believe that the mortality and morbidity rates of these patients will be reduced after triage treatment and referral to appropriate centers.
Açıklama
Anahtar Kelimeler
İlk ve Acil Yardım, Emergency and First Aid, Çoklu travma, acil servis, RTS, GAP, EMTRAS, INR, Baz Defisiti, mortalite, Multiple trauma, emergency room, RTS, GAP, EMTRAS, INR, Base Deficit, mortality
