Pediatrik penetran toraks yaralanmalarında prognozu etkileyen faktörlerin değerlendirilmesi

Amaç: Bu çalışmada pediatrik penetran toraks yaralanmasına maruz kalan hastaların sağkalım ve klinik sonuçlarını etkileyen prognostik faktörler araştırıldı. Çalışma planı: Son 20 yılda hastanemizde tedavi edilen toplam 267 (217 erkek, 50 kadın; ort. yaş 10.8 yıl; dağılım, 3-17 yıl) pediatrik penetran toraks yaralanması hastası geriye dönük olarak incelendi. Penetran toraks yaralanmaları üç gruba ayrıldı: kesici delici alet yaralanmaları, ateşli silah yaralanmaları, patlayıcı yaralanmaları. Hastaların yaşı, cinsiyeti, Yeni Yaralanma Şiddeti Skoru, yaralanma tipi, toraks travmasına eşlik eden yaralanmaları, uygulanmış tedavi şekilleri, komplikasyonları, hastanede kalış süreleri ve morbidite ve mortalite sonuçları incelendi. Yaralanma tipleri, Yeni Yaralanma Şiddeti Skoru, hastanede kalış süreleri ve komplikasyonları ile prognostik özellikleri karşılaştırıldı. Bulgular: Hastaların 103’ü ateşli silah yaralanması, 128’i kesici delici alet yaralanması ve 36’sı patlayıcı yaralanmasına maruz kalmıştı. Penetran toraks yaralanmalarının 211’u (%79) izole yaralanma iken 56’sı (%21) eşlik eden toraks dışı yaralanma idi. Ortalama Yeni Yaralanma Şiddeti Skoru 13±10 idi. Hastaların 50’si (%18.6) yalnız medikal tedavi, 199’u (%74.5) tüp torakostomi ve 18’i (%6.7) torakotomi ile tedavi edildi. Elli bir hastada (%19) komplikasyon gelişti. Hastanede kalış süresi 9±2.7 gün idi. Yirmi bir hasta (%7.9) hayatını kaybetti. Yeni Yaralanma Şiddeti Skorları, kombine yaralanma, komplikasyon, hastanede kalış süresi ve mortalite oranları patlayıcı yaralanmalarında daha yüksek idi (p

Evaluation of factors affecting prognosis in penetrating thoracic injuries

Background: This study aims to investigate the prognosticfactors affecting survival and clinical outcomes in patientsexposed to pediatric penetrating thoracic injury.Methods: A total of 267 pediatric penetrating thoracicinjury patients (217 males, 50 females; mean age 10.8 years;range, 3 to 17 years) who were treated at our hospital duringthe recent 20 years were analyzed retrospectively. Penetratingthoracic injuries were divided into three groups: incisive/stabbinginjuries, gunshot injuries, explosive injuries. Patients’ age, gender,New Injury Severity Score, injury type, injuries accompanyingthoracic trauma, types of treatment applied, length of hospitalstay, and morbidity and mortality outcomes were examined.Their prognostic characteristics were compared to their injurytypes, New Injury Severity Scores, lengths of hospital stay andcomplications.Results: Of the patients, 103 were exposed to gunshot injuries,128 to incisive/stabbing injuries, and 36 to explosive injuries. Ofthe penetrating thoracic injuries, while 211 (79%) were isolatedinjuries, 56 (21%) were accompanying non-thoracic injuries.Mean New Injury Severity Score was 13±10. Of the patients,50 (18.6%) were treated with medical therapy alone, 199 (74.5%)with tube thoracostomy, and 18 (6.7%) with thoracotomy. Fiftyonepatients (19%) developed complications. Length of hospitalwas 9±2.7 days. Twenty-one patients (7.9%) died. New InjurySeverity Scores, rates of combined injuries, complications,length of hospital stay, and mortality were higher in explosiveinjuries (p

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