Toraks Travması Geçiren 221 Hastanın Retrospektif Analizi: Tek Merkezli Bir Deneyim

Year 2025, Volume: 6 Issue: 3, 312 - 319, 28.09.2025

Kadir Baturhan Çiflik , Özgün Aran , Salih Kür

https://doi.org/10.47482/acmr.1703226

Abstract

Amaç: Toraks travmaları, tüm travma olgularının dörtte birini oluşturmaktadır. Pulmoner ve kardiyovasküler yapılar etkilendiğinde yüksek mortalite oranları görülmektedir. Bu çalışmanın amacı, toraks travması geçiren hastaların kapsamlı bir analizini yapmaktır. Ayrıca, yaralanma türlerinin ve tedavi süreçlerinin hasta sonuçlarına etkisi değerlendirilmiştir.
Yöntemler: Bu retrospektif çalışma, Aralık 2022 ile Aralık 2024 tarihleri arasında Türkiye'deki tek bir merkezde yürütülmüştür. Toraks travması olan erişkin hastalar (≥18 yaş) çalışmaya dahil edilmiştir. Hastaların demografik özellikleri, yaralanma tipleri, tedavi yöntemleri ve sonuçları analiz edilmiştir.
Bulgular: Toplam 221 toraks travmalı hasta değerlendirildi. En yaygın travma mekanizmaları düşme (n=94, %42.5) ve trafik kazasıydı (n=94, %42.5). En sık tespit edilen yaralanma kaburga kırığıydı (n=154, %53.7) ve en çok tercih edilen tedavi yöntemi konservatif yaklaşımdı (n=189, %85.5). Kaburga kırığı olan hastaların yoğun bakım ünitesinde (YBÜ) ve genel hastanede yatış süreleri anlamlı olarak daha uzundu (Z=-2.435, p=0.015 ve Z=-2.979, p=0.003). Tüp torakostomi uygulanan hastalarda kaburga kırığı sayısı konservatif tedavi edilenlere göre anlamlı olarak daha fazlaydı (t=-44.931, p=0.011). Ayrıca, bu hastalarda YBÜ ve hastanede yatış süresi daha kısaydı (Z=-2.531, p=0.011; Z=-7.234, p<0.01). Altmış dört hastada (%29) eşlik eden ekstratorasik yaralanma mevcuttu. Bunlar arasında en sık görülen ekstremite yaralanmalarıydı (n=32, %33.7). Ekstratorasik travması olan hastalarda kaburga kırığı sayısı daha fazla ve YBÜ ile hastanede yatış süreleri anlamlı olarak daha uzundu (Z=-3.361, p=0.001; Z=-6.717, p<0.05; Z=-6.843, p<0.05). On hastada (%4.5) mortalite gözlendi.
Sonuç: Hemotoraks ve pnömotoraks gibi komplikasyonların gelişmesi, YBÜ ve hastanede yatış sürelerinin uzamasıyla ilişkilidir. Toraks travmasına eşlik eden ekstratorasik yaralanmaların yetersiz yönetimi, artan mortalite oranlarına katkıda bulunabilir.

Keywords

ekstratorasik yaralanma , hemotoraks , pnömotoraks , kaburga kırığı , toraks travması

Ethical Statement

Çalışma için etik onay, Kırıkkale Üniversitesi Etik Kurulu’ndan alınmıştır (Karar No: 2025.02.28).

Supporting Institution

Yok

Thanks

Yok

Retrospective Analysis of 221 Patients with Thoracic Trauma: A Single-Center Experience

Abstract

Background: Thoracic trauma accounts for one-quarter of all trauma cases. When pulmonary and cardiovascular structures are affected, high mortality rates are observed. This study aimed to conduct a comprehensive analysis of patients who sustained thoracic trauma. In addition, the study sought to evaluate the impact of injury types and treatment processes on patient outcomes.
Methods: This retrospective study was conducted at a single center in Turkey between December 2022 and December 2024. Adult patients (≥18 years) with thoracic trauma were included. Demographic features, injury types, treatment modalities, and outcomes were analyzed.
Results: A total of 221 patients with thoracic trauma were evaluated. The most common mechanisms of trauma were falls (n=94, 42.5%) and motor vehicle accidents (n=94, 42.5%). Rib fractures were the most frequently detected injury (n=154, 53.7%), and conservative treatment was the most commonly preferred approach (n=189, 85.5%). Patients with rib fractures had significantly longer the intensive care unit (ICU) and overall hospital stay durations (Z=-2.435, p=0.015 and Z=-2.979, p=0.003). The number of rib fractures was significantly higher in patients who underwent tube thoracostomy compared to those managed conservatively (t=-44.931, p=0.011). Additionally, both ICU and hospital stay duration were shorter in these patients (Z=-2.531, p=0.011; Z=-7.234, p<0.01). Sixty-four patients (29%) had concomitant extrathoracic
injuries. Among these, extremity injuries were the most common (n=32, 33.7%). Patients with extrathoracic trauma had a higher number of rib fractures and significantly longer ICU stay duration and hospital stay duration (Z=-3.361, p=0.001; Z=-6.717, p<0.05; Z=-6.843, p<0.05). Mortality was observed in 10 patients (4.5%).
Conclusion: The development of complications such as hemothorax and pneumothorax is associated with prolonged ICU and hospital stays. Inadequate management of extrathoracic injuries accompanying thoracic trauma may contribute to increased mortality rates.

Keywords

extrathoracic injury , hemothorax , pneumothorax , rib fracture , thoracic trauma

Ethical Statement

Ethical approval for the study was obtained from the Ethics Committee of Kırıkkale University (Decision No: 2025.02.28).

Supporting Institution

None.

Thanks

None.

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