Murat Nihat ARSLAN, Merve Temel DAĞ, Mehmet Ali DAĞ, Cemalettin MAKCA

Ulaşım yaralanmaları sonrası meydana gelen ölümlerde travma bulgularının değerlendirilmesi

AMAÇ: Bu çalışmanın amacı ulaşım yaralanmalarında mey- dana gelen ölümleri değerlendirmek ve kişilerin kaza anındaki yeri ile yaralanmanın ağırlığı ve lokalizasyonu arasındaki ilişkiyi belirlemektir. YÖNTEM: Adli Tıp Kurumu Morg İhtisas Dairesi’nde 01.12.2019-30.11.2020 tarihleri arasında ulaşım yaralanmaları nedeniyle otopsisi yapılan 340 vakanın verileri incelenmiştir. BULGULAR: Vakalardaki erkek kadın oranı 4,2: 1, yaş ortala- ması 39,9±20,3’tür. Erkeklerin ve motosikletlilerin yaşları daha küçüktür. Vücut sıvılarında etil alkol saptanan kişilerde travma skorları (ISS ve NISS puanları) daha yüksektir. En sık görülen grup yaya ve motosikletliler olup bunlarda kafa kırıkları daha fazla görülmektedir. Yayalarda bölgesel olarak batın ve eks- tremite yaralanması, kırıklar arasında da pelvis kırıkları diğer gruplara göre daha fazla görülmüştür. Ön koltuk yolcuları ve sü- rücülerin ISS ve NISS puanları daha yüksektir. Otobüs-minibüs yolcularında yaşamla bağdaşmayan masif göğüs yaralanması anlamlı olarak yüksektir. Tır içinde olan vakaların ISS ve NISS puanları anlamlı olarak daha düşüktür. Yayalara çarpan araç otobüs-minibüs ve kamyon-kamyonet olduğunda yaşamla bağ- daşmayan beyin sapı yaralanmaları, motosiklet çarpmalarında ise baş bölgesi yaralanmaları anlamlı olarak daha yüksektir. SONUÇ: Ulaşım yaralanmalarını azaltıcı stratejileri belirle- mek, travma lokalizasyon ve ağırlığını belirlemek, etkin tanı ve tedavi uygulamak için başta kaza anındaki konum ve araç tipi bilgileri olmak üzere yaralanmaya etki eden faktörlerin bütüncül bir yaklaşımla tespit edilmesi gerekmektedir.

Evaluation of traumatic findings among cases died due to transportation injuries

INTRODUCTION: The objective of this study was to evalua- te deaths occurring in transportation injuries and to determine the relationship between the location of the persons at the time of the accident and the severity/localization of the injury. METHODS: The data of 340 autopsy cases due to trans- portation injuries which performed between 01.12.2019 and 30.11.2020 at the Morgue Department of Forensic Medicine were analyzed. RESULTS: The male to female ratio in the cases was 4.2: 1, and the average age was 39.9 ± 20.3. Men and motorcyclists were younger in age. Trauma scores (ISS and NISS scores) were higher in people with ethyl alcohol in their body fluids. The most common group was pedestrians and motorcyclists, and cranial fractures were more common in these groups. In pedestrians, abdominal and extremity injuries and pelvic fractures were more common than other groups. Front-seat passengers and drivers had higher ISS and NISS scores. Massive chest injuri- es, one of the unsurvivable injuries, were significantly higher in bus-minibus passengers. The ISS and NISS were were signifi- cantly lower in the truck collision cases. Brainstem injuries one of the unsurvivable injuries were higher in pedestrians in which hit by bus-minibus or a truck-van. When hitting vehicle was a motorcycle, head injuries were significantly higher. CONCLUSION: To determine strategies to reduce trans- portation accidents, detect the severity and localization of the trauma, provide appropriate diagnosis and to give effective tre- atment, it was crucial to define the factors affecting the injury including the localization of the deceased in the vehicle at the time of the accident, and vehicle type information with a holistic approach..

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