Üçüncü Basamak Üniversite Hastanesi Acil Servisine Başvuran Travma Hastalarının Özellikleri: Bir Yıllık Kesit Analizi

Giriş Travma, tüm dünyada önemli bir morbidite ve mortalite sebebidir. Bu nedenle, travma hastalarının acil servis başvuruları büyük bir önem arz etmektedir. Travmanın önlenebilir nedenlerini ortaya koymak ve engellemek, hasta bakım kalitesini arttırmak, hastaların yaşam kalitelerine önemli ölçüde etki edecektir. Bu çalışmanın amacı, acil servise başvuran travma hastalarının özelliklerini belirleyip, hastaların sahip olduğu patolojilerin mortaliteye etkisini değerlendirmektir. Gereç ve Yöntem Bu çalışmada; 1 Ocak 2019 ve 31 Aralık 2019 tarihleri arasında üçüncü basamak acil servisimize başvuran 14423 travma hastası, hastane bilgi yönetim sistemi kullanılarak retrospektif olarak değerlendirilmiştir. Elde edilen verilerin analizinde SPSS ve MEDCALC programından yararlanılmıştır. Bulgular Çalışmamıza alınan 14423 hastanın 8948’inin (%62) erkek, 5475’inin (%38) kadın olduğu saptanmıştır. Hastaların ortanca yaş değerinin 24 (IQR:25) olduğu sonucuna varılmıştır. Hastaların 1680’inde (%11,6) kafa travması, 203’ünde (%1,4) spinal travma, 461’inde (%3,2) toraks travması, 209’unda (%1,5) abdomen travması, 4157’sinde (%28,8) ekstremite travması ile ilgili patoloji saptanmıştır. Çalışmaya dahil edilen hastaların 12630’u (%87,6) acil servisten taburcu edilmiş, 1747’sinin (%12,1) hastaneye yatışı gerçekleşmiş, 16’sı (%0,111) acil serviste hayatını kaybetmiş, 30’u (%0,2) başka hastaneye sevk edilmiştir. Hastaneye yatırılan 1747 hastanın 940’ı (%53,8) yatışları süresince en az bir defa opere edilmişlerdir. Hastaneye yatan hastaları 43’ü (%2,4) ise yatışından sonra hayatını kaybetmiştir. Çalışmaya dahil edilen hastaların sahip olduğu patolojilerin mortaliteye etkisi değerlendirildiğinde; skalp kesilerinin olması, ventriküler hemoraji, subaraknoid hemoraji, spinal fraktür, kot fraktürü, akciğer kontüzyonu, batın içi serbest sıvı varlığı istatistiksel açıdan mortalite ile ilişkili bulunmuştur. Sonuç Acil servis başvuruları arasında önemli bir paya sahip olan travma hastalarının epidemiyolojik özelliklerinin, mevcut travmaların ve travma mekanizmalarının bilinmesi hastalarda yol açabilecek morbidite ve mortaliteyi öngörmede büyük ölçüde yol gösterecektir. Hasta bakım kalitesini artırabilmek, morbidite ve mortaliteye etki edebilmek için daha kapsamlı ve çok merkezli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Acil Servis, Travma, Epidemiyoloji

Characteristics of Trauma Patients Admitted to a Tertiary Care University Hospital Emergency Service: One year Cross-sectional Analysis

ABSTRACT Introduction Trauma is a important cause of mortality and morbidity in the world. Lay out and prevent the causes of trauma will significantly affect the quality of patient care and the quality of patients' lives. The purpose of this study is to identify the characteristics of trauma patients who refer to the emergency room and assess the mortality impact of pathologies that patients have. Material and Methods In this study, 14423 trauma patients who admitted to tertiary care emergency department between January 1, 2019 and December 31, 2019 were retrospectively evaluated by using the hospital information management system. The trauma types of these patients were evaluated together with their radiological imaging, and their effects on hospital discharge, hospitalization and survival were evaluated. The analysis of the data obtained has reached by SPSS and MEDCALC program. Results It was determined that 8948 (62%) of 14423 patients included in our study were male and 5475 (38%) were female. It was found that the median age of the patients was 24 (IQR:25). 1680 (11.6%) of patients had head trauma, spinal trauma in 203 (1.4%), thorax trauma in 461 (3.2%), abdomen trauma in 209 (1.5%), and extremity related trauma in 4157 (28.8%) patients were found in the study. In our study, 12630 (87.6%) were discharged from the emergency department, 1747 (12.1%) were hospitalized, 16 (0.111%) died in the emergency room, and 30 (0,2%) of patients were transferred to another hospital. 1747 patients who were hospitalized, 40 (53.8%) of them were operated at least once during their hospitalization. 43 patients (2.4%) died after hospitalization. When the effects of the pathologies of the patients included in the study on mortality were evaluated; presence of scalp incisions, ventricular hemorrhage, subarachnoid hemorrhage, spinal fracture, rib fracture, lung contusion, presence of intra-abdominal fluid were statistically significant with mortality. Conclusion Knowing the epidemiological characteristics, current trauma and trauma mechanisms of trauma patients with a significant share in emergency services admissions will be important in predicting morbidity and mortality. Comprehensive and multicenter studies are needed more to increase the quality of patient care and to effect morbidity and mortality.

Keywords:

Emergency service, Trauma, Epidemiology.,

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