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Retrospective Evaluation Of Patients Who Were Treated In The Intensive Care Unit Due To Road Traffic Accidents

Yıl 2023, Cilt: 7 Sayı: 3, 219 - 225, 31.12.2023
https://doi.org/10.30565/medalanya.1293559

Öz

Aim:We aimed to investigate intensive care unit (ICU) treatments and factors associated with mortality in patients admitted to the ICU after road traffic accidents(RTAs).

Methods:This study retrospectively analyzed patient comorbidities,features of traumas,alcohol use,Revised Trauma Score(RTS), interventions performed,ICU and hospital stays,the presence and extent of invasive mechanical ventilation(IMV),Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Scores (SAPS II), as well as Glasgow Coma Scale (GCS) and NRS 2002 (Nutritional Risk Screening 2002) scores upon admission to the ICU. Brain death rates, transfusion rates, and ICU death rates were analyzed.

Results: 90 of the 109 patients treated in the ICU for RTAs survived, and 19 patients (17.4%) died.GCS scores were lower and APACHE II scores were greater in the non-surviving patients than in the surviving patients (p < 0.0001). The number of patients who received cardiopulmonary resuscitation (CPR) was significantly higher in the non-surviving patient group(p < 0.0001).The most frequent etiology of trauma was non-vehicle traffic accidents(45%).The head was the most common site of traumas(71.5%).The GCS and RTS scores of non-survivor patients were significantly lower(p = 0.013,p = 0.001,respectively), and the APACHE II and SAPS II scores were higher(p < 0.001).It was found that the rates of intubation(100%),CPR(47.4%), and IMV(100%) in non-surviving patients outweighed in surviving patients( p= 0.005,p < 0.001, and p = 0.012,respectively).

Conclusion:Multiple parameters are influential for determining the prognoses of patients treated in the ICU for traumas caused by RTAs.In particular,a high APACHE II score and CPR requirement are associated with mortality.

Kaynakça

  • 1. Razzaghi A, Soori H, Abadi A, Khosravi A. World Health Organization's estimates of death related to road traffic crashes and their discrepancy with other countries' national report. J Inj Violence Res. 2020;6;12(3):39–44. doi: 10.5249/jivr.v12i3.1425.
  • 2. T.C. İstatistik Kurumu Başkanlığı (TÜİK) Haber Bülteni. Ölüm Nedeni İstatistikleri, 2019 Verileri. Sayı: 33710, 24 .06. 2020 Erişim: 24 .06.2020 https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2019-33710
  • 3. Shamim M. Pattern of Injuries from Road Traffic Accidents Presented at a Rural Teaching Institution of Karachi. Indian J Surg. 2017;79(4):332-7. doi: 10.1007/s12262-017-1605-3.
  • 4. Bacchieri G, Barros AJ. Traffic accidents in Brazil from 1998 to 2010: many changes and few effects. Rev Saude Publica. 2011;45(5):949-63. doi: 10.1590/s0034-89102011005000069.
  • 5. Moafian G, Aghabeigi MR, Heydari ST, Hoseinzadeh A, Lankarani KB, Sarikhani Y. An epidemiologic survey of road traffic accidents in Iran: analysis of driver-related factors. Chin J Traumatol. 2013;16(3):140-4. PMID: 23735547.
  • 6. Ünlü AR, Ülger F, Dilek A, Barış S, Murat N, Sarıhasan B. Evaluation of the Relationship Between Revised Trauma Score, and Trauma and Injury Severity Scores with Prognosis of Trauma Patients in Intensive Care Unit. Türk Anest Rean Der Dergisi. 2012;40(3):128-35. doi: 10.5222/JTAICS.2012.128.
  • 7. Galvagno SM Jr, Massey M, Bouzat P, Vesselinov R, Levy MJ, Millin MG, et al. Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage.Prehosp Emerg Care. 2019;23(2):263-70. doi: 10.1080/10903127.2018.1489019.
  • 8. Norouzi V, Feizi I, Vatankhah S, Pourshaikhian M. Calculation of the probability of survival for trauma patients based on trauma score and the injury severity score model in fatemi hospital in ardabil. Arch Trauma Res. 2013;2(1):30-5. doi: 10.5812/atr.9411.
  • 9. Yousefzadeh-Chabok S, Hosseinpour M, Kouchakinejad-Eramsadati L, Ranjbar F, Malekpouri R, Razzaghi A, et al.Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for mortality prediction in elderly trauma patients. Ulus Travma Acil Cerrahi Derg. 2016;22(6):536-40. doi: 10.5505/tjtes.2016.93288.
  • 10. Bener A, Rahman YS, Mitra B. Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country. Int Emerg Nurs. 2009;17(1):52-9. doi: 10.1016/j.ienj.2008.07.007.
  • 11. Chelly H, Bahloul M, Ammar R, Dhouib A, Mahfoudh KB, Boudawara MZ, et al. Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU "analysis of 694 cases". Eur J Trauma Emerg Surg. 2019;45(2):245-53. doi: 10.1007/s00068-017-0885-4.
  • 12. Pogorzelski GF, Silva TA, Piazza T, Lacerda TM, Spencer Netto FA, Jorge AC,et al. Epidemiology, prognostic factors, and outcome of trauma patients admitted in a Brazilian intensive care unit. Open Access Emerg Med. 2018;10:81-8. doi: 10.2147/OAEM.S162695.
  • 13. Adıyaman E , Tokur ME , Bal ZM , Gökmen AN ,Koca U. Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit. Turkish J Intensive Care. 2019;17(3):146-53. doi: 10.4274/tybd.galenos.2018.82905.
  • 14. Yazar MA, Sarıkuş Z, Horasanlı E. Thirty-day Mortality Outcomes of Trauma Patients in the Intensive Care Unit: A Three-year Retrospective Study. Turk J Intensive Care. 2019;17(1):18-24. doi: 10.4274/tybd.galenos.2018.75437.
  • 15. Papadimitriou-Olivgeris M, Panteli E, Koutsileou K, Boulovana M, Zotou A, Marangos M, et al. Predictors of mortality of trauma patients admitted to the ICU: a retrospective observational study.Braz J Anesthesiol. 2021;71(1):23-30. doi: 10.1016/j.bjane.2020.12.006.
  • 16. Zhao XJ, Kong LW, DU DY, Su HJ. Analysis on care outcome of patients with polytrauma and coma. Chin J Traumatol. 2007;10(1):53-8. PMID: 17229352.
  • 17. Kara İ, Altınsoy S, Gök U, Onur A, Sarıbapıcçı R. Mortality Analysis of Trauma Patients in General Intensive Care Unit of a State Hospital. Türk Yogun Bakim Dernegi Dergisi. 2015;13(2):68-74. doi: 10.4274/tybdd.54154.
  • 18. Atrash AK, de Vasconcellos K. Low albumin levels are associated with mortality in the critically ill: A retrospective observational study in a multidisciplinary intensive care unit. South Afr J Crit Care. 2020;36(2):74-9. doi: 10.7196/SAJCC.2020.v36i2.422.
  • 19. Taşdemir BB, Tüfek D, Sıvacı R, Doğan İ. Retrospective Analysis of the Prognosis in Trauma Patients Followed up in Intensive Care Unit. Turkiye Klinikleri J Anest Reanim. 2017;15(3):89-94. doi: 10.5336/anesthe.2017-56978.
  • 20. Wafaisade A, Wutzler S, Lefering R, Tjardes T, Banerjee M, Paffrath T, et al. Trauma Registry of DGU. Drivers of acute coagulopathy after severe trauma: a multivariate analysis of 1987 patients. Emerg Med J. 2010;27(12):934-9. doi: 10.1136/emj.2009.088484.
  • 21. Pape HC, Moore EE, McKinley T, Sauaia A. Pathophysiology in patients with polytrauma. Injury. 2022;53(7):2400-12. doi: 10.1016/j.injury.2022.04.009.

Karayolu Trafik Kazaları Nedeniyle Yoğun Bakım Ünitesinde Takip Ve Tedavi Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

Yıl 2023, Cilt: 7 Sayı: 3, 219 - 225, 31.12.2023
https://doi.org/10.30565/medalanya.1293559

Öz

Amaç: Karayolu trafik yaralanması sonrası yoğun bakım ünitesine(YBÜ) kabul edilen hastalarda ybü süreçleri ve mortalite ile ilişkili faktörleri incelemeyi amaçladık.

Yöntemler: Bu çalışmada retrospektif olarak hastaların komorbiditeleri, travmaların özellikleri, alkol kullanımı, Revize Travma Skoru (RTS), yapılan girişimler, yoğun bakım ve hastanede kalış süreleri, invaziv mekanik ventilasyonun (IMV) varlığı ve süresi, yoğun bakım ünitesine kabul sırasında;Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi ( APACHE II), Basitleştirilmiş Akut Fizyoloji Skorları (SAPS II) ve ayrıca Glasgow Koma Ölçeği (GCS) ve NRS 2002 (Beslenme Risk Taraması 2002) puanları incelendi. Beyin ölümü oranları, transfüzyon oranları ve yoğun bakım ünitesindeki ölüm oranları analiz edildi.

Bulgular: YBÜ'de RTA nedeniyle tedavi edilen 109 hastanın 90'ı hayatta kaldı ve 19 hasta (%17,4) öldü. Ölen hasta grubunda, sağ kalan hasta grubuna göre GKS skoru daha düşük ve APACHE II skorları yüksekdi (p<0.0001). Resusitasyon( KPR) uygulanan hasta sayısı, ölen hasta grubunda anlamlı şekilde yüksekdi (p<0.0001).En sık travma etyolojisi araç dışı trafik kazası idi (%45) . En sık %71,5 ile kafa travması görüldü.Ölen hastaların GKS ve RTS skorları , anlamlı düzeyde düşük olup (p:0.013) (p:0.001), APACHE II ve SAPS II skorları yüksek idi (p<0.001).Ölen hastaların entübe edilme (%100),KPR uygulanma (%47,4) ve IMV yapılma oranını (%100), sağ kalan hastalardan anlamlı düzeyde yüksek bulduk (p:0.005)(p<0,001) (p:0.012).

Sonuç: Karayolu trafik kazasına bağlı travma nedeniyle yoğun bakımda takip ve tedavi edilen hastaların prognoz tayininde farklı parametrelerin etkili olduğunu ve özellikle yüksek APACHE II ve KPR uygulanmasının mortalite ile ilişkili olduğu kanaatindeyiz.

Kaynakça

  • 1. Razzaghi A, Soori H, Abadi A, Khosravi A. World Health Organization's estimates of death related to road traffic crashes and their discrepancy with other countries' national report. J Inj Violence Res. 2020;6;12(3):39–44. doi: 10.5249/jivr.v12i3.1425.
  • 2. T.C. İstatistik Kurumu Başkanlığı (TÜİK) Haber Bülteni. Ölüm Nedeni İstatistikleri, 2019 Verileri. Sayı: 33710, 24 .06. 2020 Erişim: 24 .06.2020 https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2019-33710
  • 3. Shamim M. Pattern of Injuries from Road Traffic Accidents Presented at a Rural Teaching Institution of Karachi. Indian J Surg. 2017;79(4):332-7. doi: 10.1007/s12262-017-1605-3.
  • 4. Bacchieri G, Barros AJ. Traffic accidents in Brazil from 1998 to 2010: many changes and few effects. Rev Saude Publica. 2011;45(5):949-63. doi: 10.1590/s0034-89102011005000069.
  • 5. Moafian G, Aghabeigi MR, Heydari ST, Hoseinzadeh A, Lankarani KB, Sarikhani Y. An epidemiologic survey of road traffic accidents in Iran: analysis of driver-related factors. Chin J Traumatol. 2013;16(3):140-4. PMID: 23735547.
  • 6. Ünlü AR, Ülger F, Dilek A, Barış S, Murat N, Sarıhasan B. Evaluation of the Relationship Between Revised Trauma Score, and Trauma and Injury Severity Scores with Prognosis of Trauma Patients in Intensive Care Unit. Türk Anest Rean Der Dergisi. 2012;40(3):128-35. doi: 10.5222/JTAICS.2012.128.
  • 7. Galvagno SM Jr, Massey M, Bouzat P, Vesselinov R, Levy MJ, Millin MG, et al. Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage.Prehosp Emerg Care. 2019;23(2):263-70. doi: 10.1080/10903127.2018.1489019.
  • 8. Norouzi V, Feizi I, Vatankhah S, Pourshaikhian M. Calculation of the probability of survival for trauma patients based on trauma score and the injury severity score model in fatemi hospital in ardabil. Arch Trauma Res. 2013;2(1):30-5. doi: 10.5812/atr.9411.
  • 9. Yousefzadeh-Chabok S, Hosseinpour M, Kouchakinejad-Eramsadati L, Ranjbar F, Malekpouri R, Razzaghi A, et al.Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for mortality prediction in elderly trauma patients. Ulus Travma Acil Cerrahi Derg. 2016;22(6):536-40. doi: 10.5505/tjtes.2016.93288.
  • 10. Bener A, Rahman YS, Mitra B. Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country. Int Emerg Nurs. 2009;17(1):52-9. doi: 10.1016/j.ienj.2008.07.007.
  • 11. Chelly H, Bahloul M, Ammar R, Dhouib A, Mahfoudh KB, Boudawara MZ, et al. Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU "analysis of 694 cases". Eur J Trauma Emerg Surg. 2019;45(2):245-53. doi: 10.1007/s00068-017-0885-4.
  • 12. Pogorzelski GF, Silva TA, Piazza T, Lacerda TM, Spencer Netto FA, Jorge AC,et al. Epidemiology, prognostic factors, and outcome of trauma patients admitted in a Brazilian intensive care unit. Open Access Emerg Med. 2018;10:81-8. doi: 10.2147/OAEM.S162695.
  • 13. Adıyaman E , Tokur ME , Bal ZM , Gökmen AN ,Koca U. Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit. Turkish J Intensive Care. 2019;17(3):146-53. doi: 10.4274/tybd.galenos.2018.82905.
  • 14. Yazar MA, Sarıkuş Z, Horasanlı E. Thirty-day Mortality Outcomes of Trauma Patients in the Intensive Care Unit: A Three-year Retrospective Study. Turk J Intensive Care. 2019;17(1):18-24. doi: 10.4274/tybd.galenos.2018.75437.
  • 15. Papadimitriou-Olivgeris M, Panteli E, Koutsileou K, Boulovana M, Zotou A, Marangos M, et al. Predictors of mortality of trauma patients admitted to the ICU: a retrospective observational study.Braz J Anesthesiol. 2021;71(1):23-30. doi: 10.1016/j.bjane.2020.12.006.
  • 16. Zhao XJ, Kong LW, DU DY, Su HJ. Analysis on care outcome of patients with polytrauma and coma. Chin J Traumatol. 2007;10(1):53-8. PMID: 17229352.
  • 17. Kara İ, Altınsoy S, Gök U, Onur A, Sarıbapıcçı R. Mortality Analysis of Trauma Patients in General Intensive Care Unit of a State Hospital. Türk Yogun Bakim Dernegi Dergisi. 2015;13(2):68-74. doi: 10.4274/tybdd.54154.
  • 18. Atrash AK, de Vasconcellos K. Low albumin levels are associated with mortality in the critically ill: A retrospective observational study in a multidisciplinary intensive care unit. South Afr J Crit Care. 2020;36(2):74-9. doi: 10.7196/SAJCC.2020.v36i2.422.
  • 19. Taşdemir BB, Tüfek D, Sıvacı R, Doğan İ. Retrospective Analysis of the Prognosis in Trauma Patients Followed up in Intensive Care Unit. Turkiye Klinikleri J Anest Reanim. 2017;15(3):89-94. doi: 10.5336/anesthe.2017-56978.
  • 20. Wafaisade A, Wutzler S, Lefering R, Tjardes T, Banerjee M, Paffrath T, et al. Trauma Registry of DGU. Drivers of acute coagulopathy after severe trauma: a multivariate analysis of 1987 patients. Emerg Med J. 2010;27(12):934-9. doi: 10.1136/emj.2009.088484.
  • 21. Pape HC, Moore EE, McKinley T, Sauaia A. Pathophysiology in patients with polytrauma. Injury. 2022;53(7):2400-12. doi: 10.1016/j.injury.2022.04.009.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Yıldız Yiğit 0000-0002-8665-6646

Nuriye Esen Bulut 0000-0002-4845-8964

Arzu Yıldırım Ar 0000-0002-5867-0897

Yayımlanma Tarihi 31 Aralık 2023
Gönderilme Tarihi 7 Mayıs 2023
Kabul Tarihi 16 Ekim 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 7 Sayı: 3

Kaynak Göster

Vancouver Yiğit Y, Esen Bulut N, Yıldırım Ar A. Retrospective Evaluation Of Patients Who Were Treated In The Intensive Care Unit Due To Road Traffic Accidents. Acta Med. Alanya. 2023;7(3):219-25.

9705 

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