Kot kırıkları sonrası komplikasyonlar ve opioid kullanımı gerekliliği, 1074 hastanın analizi

Abstract

Amaç: Bu çalışma, kaburga kırıklarının risk faktörlerini, ilişkili komplikasyonları, opioid gereksinimini ve ölüm oranlarını değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: 1 Ocak 2016 ile 30 Eylül 2020 tarihleri arasında acil servise başvuran ve kot kırığı olan hastalar retrospektif olarak incelendi. Hastaların demografik verileri, kot kırığının özellikleri, travma mekanizması, ilişkili komplikasyonlar, hastanede kalış süreleri ve hastane içi mortalite kaydedildi. Bulgular: Çalışmaya toplam 1074 hasta dahil edildi. Hastaların çoğu erkekti (n = 748, %69.6) ve ortalama yaş 53.89 ± 15.31 yıldı. Ortalama kırık kot sayısı 3.65 ± 2.06 idi. Diyafram yırtığı, atelektazi, pnömoni, ARDS, pnömomediasten, akciğer herniasyonu, yelken göğüs ve ampiyemi olan tüm hastalarda altı veya daha fazla kot kırığı vardı. Ölen ve hayatta kalan hastaların karşılaştırılmasında, yaş, cinsiyet, kaburga kırığı tarafı, kırık kaburga sayısı ve eşlik eden başka bir organ yaralanması açısından istatistiksel olarak anlamlı farklılıklar mevcuttu. Kırık kot sayısı ile pnömotoraks, hemotoraks, göğüs tüpü, opioid kullanımı ve hastanede kalış süresi arasında orta-güçlü bir korelasyon bulundu. Sonuç: Kırık kot sayısının artması, artan komplikasyonlar, opioid kullanımı ve hastanede kalış süresi ile ilişkiliydi. Altı ve daha fazla kırığı olan hastalarda ölüm oranı %8.8 idi. Araç içi trafik kazaları en yaygın mekanizmaydı. Tedbirler iyileştirilirse kot kırıklarının büyük bir kısmı önlenebilir.

Keywords

• hemotoraks
• kaburga kırığı
• opioid kullanımı
• pnömotorax
• yelken göğüs

Complications, and requirement of opioid use after rib fractures, an analysis of 1074 patients

Abstract

Aim: This study was aimed to evaluate the risk factors, associated complications, opioid requirements, and mortality rates of rib fractures. Materials and Methods: Patients with rib fractures who were admitted to the emergency department between January 1, 2016, and December 31, 2020, were retrospectively analyzed. Patients' demographic data, rib fracture characteristics, trauma mechanism, associated complications, length of stay in the hospital, and in-hospital mortality were recorded. Results: A total of 1074 patients were included in the study. Most of the patients were male (n = 748, 69.6%) and the mean age was 53.89 ± 15.31 years. The mean number of fractured ribs was 3.65 ± 2.06. All patients with diaphragm laceration, atelectasis, pneumonia, ARDS, pneumomediastinum, lung herniation, flail chest, and empyema had six or more rib fractures. Comparison of died and survived patients showed statistically significant differences for age, gender, side of rib fracture, number of fractured ribs, and accompanying another organ injury. A moderate-strong correlation was found between the number of fractured ribs and pneumothorax, hemothorax, chest tube, opioid use, and length of stay in the hospital. Conclusion: Increased number of fractured ribs were associated with increased complications, opioid use, and length of stay in the hospital. The mortality rate was 8.8% in patients with 6 or more fractures. In-vehicle traffic accidents were the most common mechanism. Many of the rib fractures can be prevented if the measures are improved.

Keywords

• flail chest
• hemothorax
• opioid use
• pneumothorax
• rib fracture

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