Faruk GÜNGÖR, Kamil Can AKYOL, Taylan KILIÇ, Mustafa KEŞAPLI, Asım ARI, Ali Vefa SAYRAÇ

Künt Minör Toraks Travması: Acil Servise Başvuran 186 Hastanın Prospektif Analizi

Amaç: Künt minör toraks travmalı (MTT) hastalarda tanı, tedavi, acil servis (AS) yönetimi ve taburculuk sonrası takip bakımındanbilgiler kısıtlıdır. Hastaların demografik verilerini, fizik muayene bulgularını ve bu bulguların eşlik eden torasik yaralanmaları öngörmedeki değerliklerini, hastaların sonlanımlarını araştırması amaçlandı.Materyal ve Metot: Yaralanma mekanizması, fizik muayene bulguları, görüntüleme bulguları, ağrı düzeyleri, taburculuk ve hastaneyeyatış tanıları prospektif olarak çalışma formuna kaydedildi. Bulgular: Çalışmaya, alınan 186 hastanın yaş ortalaması 48±17 (18–91) 131’i (%70,4) erkekti. Hastaların 171’i (%91,9) acil servisten taburcu edilirken, 15’i (%8,1) hastaneye yatırıldı. En sık tanı, yumuşak doku travması (%78,8) ve en sık muayene bulgusu yaralanma yerinde duyarlılıktı (%69,6). Duyarlılıkları çok düşük olsa da fizik muayene bulguları eşlik eden torasik yaralanmaları saptamadaki özgüllükleri %100 bulundu. Tekrarlayan başvurusu olan hastaların başlangıç ve 7. gündeki ağrı düzeyleri istatistiki olarak daha yüksek saptandı (p=0,019, p=0,025).Sonuç: MTT’lı çoğu hasta, önemli bir morbidite ve mortalite olmadan AS’den taburcu edilmektedir. Pozitif fizik muayene bulgularıbulunan hastalar, eşlik eden torasik yaralanmalar açısından detaylı araştırılmalıdır. Ciddi ve uzun süren ağrı tekrar başvuruların belirleyicileri olduğundan yeterli analjezik tedavi sağlanarak ağrı konusunda hastalar detaylı bilgilendirmelidir.

Anahtar Kelimeler:

minör künt toraks travması, fizik muayene, ağrı ve analjezi

Blunt Minor Thoracic Trauma: A Prospective Analysis of 186 Patients in the Emergency Department

Aim: There is limited information regarding patients with blunt minor thoracic traumas (MTT) in terms of diagnosis, treatment, emergency department (ED) management and follow-up after discharge. The aim of this research, was to investigate demographics, physical examination findings and their predictive value for concomitant thoracic injuries, and outcomes of patients. Material and Method: The mechanism of injury, physical examination findings, radiographic findings, pain levels, discharge and hospitalization diagnoses were recorded prospectively. Results: A total of 186 patients with a mean age of 48±17 (18– 91) years were included in the study. 131 of the (70.4%) patients were males. 171 of the patients (91.9%) were discharged, while 15 (8.1%) patients were hospitalized. The most common diagnosis and physical finding were soft tissue trauma, and tenderness at injury site (78.8%, 15.1%, 69.6%), respectively. The specificity of physical findings in predicting concomitant thoracic injuries were found to be 100%, although their sensitivities were too low. The initial and 7th day pain levels of the patients with recurrent admissions were significantly higher (p=0.019, p=0.025). Conclusion: Most patients are discharged from ED without significant morbidity and mortality. Patients exhibiting the positive physical findings require detailed investigation for concomitant thoracic injuries. As severe and long-lasting pains are determinants of hospital re-admissions, it would be appropriate to provide adequate analgesia and detailed information about the pain.

Keywords:

minor blunt thoracic trauma, physical examination, pain and analgesia,

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