Kedilerin Travmaya Bağlı Acil Durumlarında Triyaj Ve Glasgow Koma Skalası Bulgularının Değerlendirmesi

Year 2022, Volume: 15 Issue: 3, 285 - 296, 30.09.2022

Oğuzhan Pınar Mustafa Arıcan

https://doi.org/10.30607/kvj.1063835

Abstract

Çalışmada kedilerde gözlenen travmalar ve bu travmalara bağlı oluşabilecek patolojik durumların hayvan travma triaj skoru (ATT) ve modifiye Glasgow koma skoru skalaları (mGCS) kullanılarak, önceden anlaşılması ve bunlara yönelik hazırlık aşaması, hastanın prognozu ve objektif değerlendirilme sonuçlarının ortaya konulması amaçlanmıştır. Çalışma materyalini Selçuk Üniversitesi Veteriner Fakültesi Cerrahi Anabilim Dalı Kliniği’ne 2020-2021 yılları arasında 10 aylık periyotta travma nedeniyle getirilen çeşitli yaş, ırk ve cinsiyetteki 30 kedi oluşturdu. Olgular 6 ay ile 2 yıl yaş ortalamalarındaydı. İskelet ve nörolojik sistem muayeneleri yapılarak mGCS ve ATT skorları belirlendi ve not edildi. Olguların klinik, radyolojik, ultrasonografik muayeneleri ve kan gazı analizleri yapıldı. Skorlama sistemi bulgularına göre 30 kedinin; 6 tanesi yeşil kod (%20) 14 tanesi sarı kod (%46.6), 10 tanesi kırmızı kod (% 33.3) ile triaj renk kodlaması yapılmıştır. Otuz kedinin ATT puan dağılımı; %3,3’ ünün 0 puana, %6,6’sının 1 puana, %23,3’ünün 2 puana, %33,3’ünün 3 puana, %6,6’sının 4 puana, %13,3’ünün 5 puana, %3,3’ünün 6 puana, %6,6’sının 8 puana ve %3,3’ünün 12 puana sahip olduğu gözlemlenmiştir. Kedilerdeki travmaya; 20 olguda yüksekten düşme, 4 olguda trafik kazası, 3 olguda ısırılmaya bağlı olduğu belirlenirken, 3 olguda neden bilinmemektedir. Kırık olgularının dağılımı ise; 3 tibia, 6 femur, 2 humerus, 2 phalanx, 2 hernia diyaframatika, 5 sakroiliak luksasyon, 1 kalkaneus luksasyonu, 2 antebrachium kırığı, 2 vertebral kırık, 1 çoklu koksa kırığı, 1 metatarsus kırığı, 2 yumuşak doku zedelenmesi ve 2 olguda çeşitli bölgelerde yara oluşumu şeklinde belirlenmiştir. Sonuç olarak modifiye Glasgow koma skalası ve hayvan travma triaj skorlamasının hekime prognoz yönünden yararlı olacağı ve hastayı daha objektif değerlendirmeyi sağladığı belirlenmiştir.

Keywords

Kedi, Travma, Travma Triaj Skorlaması, Modifiye Glasgow Koma Skalası

Supporting Institution

Selçuk Üniversitesi, BAP Koordinatörlüğü

Project Number

21202133

Evaluation of Triage and Glasgow Coma Scale Findings in Cats in Trauma Emergencies

Abstract

In the study, it was aimed to understand the traumas which was observed in cats and the pathological conditions that may occur due to these traumas by using animal trauma triage score (ATT) and modified Glasgow coma score scales (mGCS), and to reveal the preparation stage for them, the prognosis of the patient and the results of objective evaluation. The study material consisted of 30 cats of various ages, breeds and genders, brought to the Department of Surgery of the Faculty of Veterinary Medicine Selçuk University in a 10-month period between 2020-2021. The mean age of the cases was between 6 months and 2 years. Skeletal and neurological system examinations were performed, and mGCS and ATT scores were determined and noted. Clinical, radiological, ultrasonographic examinations and blood gas analyzes of the cases were performed. According to the scoring system findings, 30 cats; triage color coding was done with 6 of them green code (20%), 14 of them yellow code (46,6%), 10 of them red code (33,3%). ATT score distribution of thirty cats; 3,3% to 0 points, 6,6% to 1 point, 23,3% to 2 points, 33,3% to 3 points, 6,6% to 4 points, 13,3% to 5 points, 3,3% to 6 points, 6,6% to 8 points and 3,3% to 12 points were observed. Trauma distributions in cats; It was determined that it was due to falling from a height in 20 cases, traffic accidents in 4 cases, and being bitten in 3 cases, while the cause is unknown in 3 cases. The distribution of fracture cases is; 3 tibia, 6 femur, 2 humerus, 2 phalanx, 2 hernia diaphragmatica, 5 sacroiliac luxation, 1 calcaneal luxation, 2 antebrachial fractures, 2 vertebral fractures, 1 multiple coxa fracture, 1 metatarsal fracture, 2 soft tissue injuries and 2 cases in various regions determined as wound formation. As a result, it has been determined that the modified Glasgow coma scale and animal trauma triage scoring will be beneficial for the clinician in terms of prognosis and provide a more objective evaluation of the patient.

Keywords

Cat, Trauma, Trauma Triage Score, Modified Glasgow Coma Scale

Project Number

21202133

References

• 1-Ali LB. Incidence, occurrence, classification and outcome of small animal fractures: a retrospective study (2005-2010). World Academy of Science, Engineering and Technology, International Journal of Biological, Biomolecular, Agricultural, Food and Biotechnological Engineering, 2013, 7(3): 191-196.
• 2-Boysen SR, Lisciandro GR. The use of ultrasound for dogs and cats in the emergency room: AFAST and TFAST. Vet Clin North Am Small Anim Pract. 2013,43(4):773-797.
• 3-Cameron S, Weltman JG, Fletcher DJ. The prognostic value of admission point-of-care testing and modified Glasgow Coma Scale score in dogs and cats with traumatic brain injuries (2007-2010): 212 cases. J Vet Emerg Crit Care 2021,1-8.
• 4-Conroy M, O’Neill DG, Boag A, et al. Epidemiology of road traffic accidents in cats attending emergency-care practices in the UK. J Small Anim Pract 2019; 60: 146–152.
• 5-Donnelly E. Leawis D. Triage of the veterinary patient, 2016, p: 6-11.
• 6-Drobatz KJ. Global Approach To The Trauma Patıent, In: Manual of Trauma Management in the Dog and Cat, Eds: Drobatz KJ, Beak MW, Syrıng RS, 1th ed. UK, John Wiley and Sons, 2011, p. 1-5.
• 7-Fossum TW. Surgery of the lower respiratory system: Pleural Cavity and Diaphragm. In: Fossum TW, ed. Small Animal Surgery. 3rd ed. China: Elsewier Mosby; 2007, p.867- 929.
• 8-Goggs R. Performance evaluation and validation of the animal trauma triage (ATT) score and modified Glasgow coma scale (mGCS) with suggested category adjustment in dogs - a VetCOT Registry study. J Vet Emerg Crit Care. San Antonio, 2019.
• 9-Hall KE, Boller M, Hoffberg J, McMichael M, Raffe MR, Sharp CR; ACVECC's Veterinary Committee on Trauma (VetCOT) Registry Subcommittee. ACVECC-Veterinary Committee on Trauma Registry Report 2013-2017. J Vet Emerg Crit Care (San Antonio). 2018 28(6):497-502.
• 10-Harris GL, Brodbelt D, Church DB, et al. Road traffic accidents (RTA) in dogs in the UK: epidemiology, clinical 8 Journal of Feline Medicine and Surgery management and outcomes. J Vet Emerg Crit Care 2018; 28: 140–148
• 11-Hernon T, Gurney M, Gıbson S. A retrospective study of feline trauma patients admitted to a referral centre. Journal of Small Animal Practice, 2018, 59(4): 243-247.
• 12-https://www.verikaynagi.com (Erişim tarihi: 01.12.2019).
• 13-Klainbart S, Shipov A, Madhala O, Oron LD, Weingram T, Segev G, Kelmer E. Dog bite wounds in cats: a retrospective study of 72 cases. J Feline Med Surg. 2021,1-9.
• 14-Lapsley JH, Galina MS, Julia P. Performance evaluation and validation of the Animal Trauma Triage score and modified Glasgow Coma Scale in injured cats: A Veterinary Committee on Trauma registry study. Journal of Veterinary Emergency and Critical Care, 2019, 29(5), 478–483.
• 15-Liehmann LM, Dörner J, Hittmair KM, Schwendenwein I, Reifinger M, Dupré G. Pancreatic rupture in four cats with high-rise syndrome. J Feline Med Surg. 2012 14(2):131-137.
• 16-Lyons BM, Ateca LB, Otto CM. Clinicopathological abnormalities associated with increased animal triage trauma score in cats presenting for vehicular trauma: 75 cases (1998-2009).J Vet Emerg Crit Care 2020, 30(6):693-697.
• 17-Murgia E, Troìa R, Bulgarelli C, et al. Prognostic significance of organ dysfunction in cats with polytrauma. Front Vet Sci 2019; 6: 189.
• 18-Nascimento DC, Costa Neto JM, Solcà MS, Estrela-Lima A, Barbosa VF. Clinicoepidemiological profile and risk factors associated with mortality in traumatized cats admitted to a veterinary teaching hospital in Brazil. J Feline Med Surg. 2021,1-8.
• 19-Öztürk G. Köpeklerde Ön Ekstremite Travmatik Lezyonlarının Dağılımı ve Sağaltım Seçenekleri, Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, 2006.
• 20-Parlak K, Arıcan M. Kedi ve Köpeklerde Travma Hastalarında Acil Yaklaşım. Türkiye Klinikleri Veteriner Bilimleri Dergisi, Basılış Tarihi 2016, 1(3):82-87.
• 21-Rockar RA, Drobatz KS, Development Of A Scoring System For The Veterinary Trauma Patient, In: The Journal Of Veterınary Emergency And Crıtıcal Care, 1994, p: 4, 2, 77-83.
• 22-Simpson SA, Syring RS, Otto CM. Severe blunt trauma in dogs: 235 cases (1997-2003). J Vet Emerg Crit Care (San Antonio), 2009, p.19(6):588- 602.
• 23-Streeter EM, Rozanski EA, Laforcade-Buress Ad, Freeman LM, Rush JE. Evaluation of vehicular trauma in dogs: 239 cases (JanuaryDecember 2001). J Am Vet Med Assoc, 2009, p.235(4):405-8
• 24-Sungur İ, Akdur R , Piyal B. Türkiye’deki Trafik Kazalarının Analizi, Ankara Med J, 2014, 14(3): 114 - 124
• 25-The Straight Dope. 1996 Do cats always land unharmed on their feet, no matter how far they fall?, Retrieved May 13, 2021.
• 26-Uzun S. Veteriner tıp acil ve yoğun bakım prosedürleri rehberi, Eds: Uzun S, 1th ed. Elyaf matbaa. 2019, p.27-30.
• 27-vetnet.ibb.gov.tr, (Erişim tarihi: .01.12.2019).
• 28-Vnuk D, Pirkic B, Maticic D, Radisic B, Stejskal M, Babic T, Kreszinger M, Stejskal M, Babic T, Lemo N. Feline high-rise syndrome: 119 cases (1998–2001). Journal of Feline Medicine and Surgery. 2004, 6 (5): 305–312.
• 29-Zimmermann E, Hittmair KM, Suchodolski JS, Steiner JM, Tichy A, Dupré G. Serum feline-specific pancreatic lipase immunoreactivity concentrations and abdominal ultrasonographic findings in cats with trauma resulting from high-rise syndrome. J Am Vet Med Assoc. 2013;1;242(9):1238-1243.