Travma Hastalarında Akut Batın Analizi: Mortalite Faktörleri ve COVID-19 Pandemisinin Yatışlar Üzerindeki Etkisi

Year 2024, Volume: 11 Issue: 2, 78 - 90, 31.08.2024

Mustafa Alpaslan , Sultan Özselçuk

https://doi.org/10.56941/odutip.1512185

Abstract

Amaç: Travmaya bağlı akut batın gelişen hastaların analizi ile mortaliteyi etkileyen faktörlerin değerlendirilmesi ile COVID-19
pandemi sürecinin hasta başvurularına etkisini incelemektir.
Yöntem: Çalışma retrospektif olarak 01.01.2019-31.12.2023 (5 yıl) tarihleri arasında ikinci basamak bir sağlık kuruluşunun acil
servisine başvuran ve travmaya sekonder acil cerrahi batın gelişen, yatırılarak tedavi altına alınan hastaların analizi ile yapıldı.
Çalışmaya tüm yaş grupları dâhil edildi. Hastalarda demografik veriler, travma tipi, tedavi tipi, yaralanan bölge, laboratuar verileri,
hastanede yatış süresi ve mortalite durumu analiz edildi. Travma tipine göre yaralanan bölgelerin karşılaştırmalı analizi yapıldı.
Taburcu olan ve ölümle sonlanan hastaların verileri karşılaştırıldı. Veri toplama işlemleri ise hastane elektronik verileri üzerinden
yapıldı.
Bulgular: Çalışmada 123 hasta değerlendirildi. Hastaların %78.9’u erkekti. Yaş ortalaması 36.43±14.81 olup en sık hasta yatışı 21-
40 yaş aralığındaydı (%60.2). Acil servise başvuru anında Glaskow Koma Skoru en sık 11-15 (%83) aralığında oldu. En fazla trafik
kazası nedeniyle başvuru olduğu görüldü (%40.7). Travma sonrası en fazla batın içinde birden fazla organ ya da bölgede yaralanma
olduğu görüldü (%28.5). Hastaların %65,9’una cerrahi işlem uygulandı. Hastanede ortalama yatış süresi 7.14±5.40 gün oldu. Eksitus
olan vakalarda başvuru anında hemoglobin düzeyi ve trombosit düzeyinin anlamlı derecede düşük olduğu görüldü (p<0.05). Mortalite
oranı %9.8’di.
Sonuç: Karın travmalı hastalarda yaralanmanın tipi, başvuru anında gözlenen Glaskow Koma Skoru ve laboratuar verileri mortaliteyi
öngörmede etkili olmaktadır. Özellikle künt travmalı hastalarda ve multi travmalı vakalarda karın içinde meydana gelen
yaralanmanın daha sinsi şekilde ilerleyebileceği ve atlanabileceği unutulmamalıdır.

Keywords

Acil Servis, Künt Abdominal Travma, Penetran Abdominal travma, Mortalite

Analysis of Acute Abdomen in Trauma Patients: Mortality Factors and Impact of the COVID-19 Pandemic on Admissions

Abstract

Objective: To analyze the patients who developed acute abdomen due to trauma, to evaluate the factors affecting mortality and to
examine the impact of the COVID-19 pandemic process on patient admissions.
Method: The study was conducted retrospectively by analyzing the patients who applied to the emergency department of a secondary
healthcare institution between 01.01.2019-31.12.2023 (5 years) and developed an emergency surgical abdomen secondary to trauma
and were hospitalized and treated. All age groups were included in the study. Demographic data, type of trauma, type of treatment,
site of injury, laboratory data, length of hospitalization and mortality status were analyzed. Comparative analysis of the injured
regions according to the type of trauma was performed. Data of patients who were discharged and those who died were compared.
Data collection was performed through hospital electronic data.
Results: The study evaluated 123 patients. The majority of patients were male (%78.9). The mean age was 36.43±14.81 years and
the most common age range was 21-40 years (60.2%). At the time of presentation to the emergency department, the most common
Glasgow Coma Score was 11-15 (83%). The most common reason for presentation was traffic accident (40.7%). Post-traumatic
injuries to more than one organ or region in the abdomen were most common (28.5%). Surgical procedures were performed in 65.9%
of the patients. The mean duration of hospitalization was 7.14±5.40 days. Hemoglobin and platelet levels were found to be
significantly lower at the time of admission in the patients who died (p<0.05). Mortality rate was 9.8%.
Conclusion: In patients with abdominal trauma, the type of injury, Glasgow Coma Score at admission and laboratory data are
effective in predicting mortality. It should be kept in mind that especially in patients with blunt trauma and in cases of multiple
trauma, intra-abdominal injuries may progress more insidiously and may be missed.

Keywords

Emergency Department, Blunt Abdominal Trauma, Penetrating Abdominal Trauma, Mortality

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