Ateşli Silah Yaralanmalarında Mortaliteyi Öngören Epidemiyolojik ve Klinik Faktörler: Seviye-1 Travma Merkezinden Retrospektif Bir Çalışma

Abstract

Amaç: Ateşli silah yaralanmaları dünya genelinde önemli bir travma morbidite ve mortalite nedenidir. Bu çalışmanın amacı, ateşli silah yaralanmalarının epidemiyolojik ve klinik özelliklerini değerlendirmek ve hastane içi mortaliteyi öngören faktörleri belirlemektir. Materyal ve Metot: Bu retrospektif kohort çalışmaya, Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi’ne 1 Ocak–31 Aralık 2024 tarihleri arasında ateşli silah yaralanması nedeniyle başvuran hastalar dahil edildi. Hastaların demografik verileri, yaralanma mekanizması, anatomik yaralanma bölgeleri, travma skorları, vital bulguları, laboratuvar değerleri, uygulanan girişimler ve klinik sonuçları değerlendirildi. Hastane içi mortalite ile ilişkili faktörleri belirlemek amacıyla univaryant lojistik regresyon analizleri yapıldı ve olasılık oranları (OR) hesaplandı. Bulgular: Toplam 119 hasta çalışmaya dahil edildi (ortalama yaş: 33,3 ± 12,8 yıl; %89,1 erkek). Genel hastane içi mortalite oranı %9,2 idi. Hayatını kaybeden hastalar arasında kadın cinsiyet ve intihar girişimi daha yaygındı. Univaryant analizlerde kadın cinsiyet (OR: 6,286), intihar girişimi (OR: 40,125), düşük Glasgow Koma Skoru (OR: 0,490), düşük Revize Travma Skoru (OR: 0,113) ve yüksek Travma Şiddet Skoru (OR: 1,323) mortalite ile ilişkili bulundu. Baş-boyun ve göğüs yaralanmaları daha yüksek mortalite, cerrahi girişim ihtiyacı ve kan transfüzyonu ihtiyacı ile ilişkiliydi. Sonuç: Ateşli silah yaralanmalarında vital bulgular, travma skorları ve anatomik yaralanma bölgelerinin erken değerlendirilmesi prognostik açıdan önemli bilgiler sağlayabilir. Mortalitenin ötesinde, bu hastalardaki yüksek yatış ve cerrahi müdahale oranları, ateşli silah yaralanmalarının sağlık sistemine olan ciddi yükünü de ortaya koymaktadır.

Keywords

• Acil bakım
• ateşli silah yaralanmaları
• mortalite
• travma skoru
• yaralanma şiddeti

Epidemiological and Clinical Predictors of Mortality in Firearm Injuries: A Retrospective Study from a Level-1 Trauma Center

Abstract

Objective: Firearm-related injuries remain a significant cause of trauma morbidity and mortality worldwide. This study aimed to evaluate the epidemiological and clinical characteristics of firearm injuries and identify predictors of in-hospital mortality. Materials and Methods: This retrospective cohort study included patients presenting with firearm injuries to Marmara University Pendik Training and Research Hospital during the period spanning from January 1 to December 31, 2024. Data on demographics, injury mechanism, anatomical injury sites, trauma scores, vital signs, laboratory findings, interventions, and outcomes were collected. Univariate logistic regression analyses were performed to identify factors associated with mortality, along with their odds ratios (OR). Results: A total of 119 patients were included (mean age: 33.3 ± 12.8 years; 89.1% male). The overall in-hospital mortality rate was 9.2%. Non-survivors were more likely to be female and have suicide-related injuries. Univariate analysis revealed that female gender (OR: 6.286), suicide intent (OR: 40.125), lower Glasgow Coma Scale (OR: 0.490), lower Revised Trauma Score (OR: 0.113), and higher Injury Severity Score (OR: 1.323) were independent predictors of mortality. Head/neck and chest injuries were associated with higher mortality and increased need for surgery and blood transfusion. Conclusions: Early assessment of vital signs, trauma scores, and anatomical injury sites can provide valuable prognostic information in firearm-related trauma. Beyond mortality, the high rates of hospitalization and surgical intervention highlight the broader burden of firearm injuries on healthcare systems.

Keywords

• Emergency care
• firearm injuries
• injury severity
• mortality
• trauma score

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