Mevlüt Okan AYDIN, Vahide Aslıhan DURAK, Erol ARMAĞAN

Acil Servise Başvuran Künt Travmalı Olgularda Fizik Muayene ve Travma Mekanizmasının Tomografi Sonuçlarıyla Karşılaştırmalı Değerlendirilmesi

Künt travma ile acil servise başvuran olgularda etkin tanı ve tedavi protokolünün belirlenmesi adına Tüm Vücut Bilgisayarlı Tomografi(TVBT) kullanımı son yıllarda önem kazanmıştır. Bu çalışmanın amacı, acil servise başvuran travma hastalarında çekilen TVBT bulgularının geriye dönük olarak incelenmesi, fizik muayene ve travma mekanizmasının travma patolojisini öngörme, morbidite ve mortalite tayininde etkisinin belirlenmesidir. Acil Servise başvuran hastaların başvuru anındaki muayene bulguları ve hekim öngörüsüne göre patoloji düşünülen olgularla, TVBT sonucu karşılaştırıldı. Çalışmamıza alınan 300 olgunun 236’i erkek 64'ü kadındı. Hastaların %51,0'ında trafik kazası, %26,3’ünde yüksekten düşme, %14,7'sinde motosiklet kazası nedeni ile künt travma meydana gelmişti. Çalışmamıza alınan 300 hastanın 186'sında (%62,0) travma ile alakalı en az bir BT bulgusu mevcut iken; hastaların 114'ünde (%38,0) herhangi bir bulguya rastlanmadı. Fizik muayenede düşünülmeyen ancak TVBT’de saptanan patolojik durumların hiçbirinin mortalite ya da morbidite üzerine etkisi olmadığı saptandı. Bu çalışma özellikle acil serviste TVBT kullanımının uygun endikasyonlarının oluşturulması ve standart bir çekim protokolünün sağlanması için yararlı olabilecektir.

An Evaluation of Physical Examination and Trauma Mechanism Comparatively with Tomography Results in Patients Attended Emergency Department with Blunt Trauma

In recent years, Whole Body Computed Tomography (WBCT) has gained prominence for the determination of effective diagnosis and treatment protocol for the patients attended the emergency department with blunt trauma. The aim of this study was to retrospectively examine the WBCT findings of trauma patients admitted to the emergency department and to determine the impacts of physical examination and trauma mechanism on the prediction of trauma pathology, morbidity and mortality. The patients' results of the physical examination performed at the time of admission to the emergency department and the cases initially diagnosed by the physician to be pathological were compared with the WBCT findings. Of the 300 cases included in our study, 236 were male and 64 were female. The blunt traumas have resulted from the road traffic accidents, falls from height and motorcycle accidents in 51%, 26.3% and 14.7% of the patients, respectively. At least one CT scan finding associated with trauma was identified among 186 (62%) of 300 patients included in our study, while there were no findings of trauma in 114 (38%) of them. None of the pathological conditions that were considered during the physical examination, but detected through WBCT scan had an effect on mortality or morbidity. This study may contribute particularly to specifying appropriate indications for the use of WBCT in our hospital and establishing a standard protocol for performing CT scans.

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