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YANIK MERKEZİNDE FİZİKİ YAPI VE SİSTEM DEĞİŞİKLİĞİNİN HASTA ÇIKTILARINA ETKİLERİ

Year 2021, Volume: 28 Issue: 3, 473 - 478, 13.09.2021
https://doi.org/10.17343/sdutfd.966455

Abstract

Amaç
Yanık yaralanmaları, dünya çapında en yaygın dördüncü
yaralanmalardır. Dünyanın farklı coğrafi bölgeleri
arasında sosyo-kültürel faktörler, gelişmişlik ve
sanayileşme seviyelerine bağlı olarak yanık demografisi
ve sonuçlarında önemli farklılıklar görülmektedir.
Bu çalışmada ciddi yanık hastalarında yanık tedavi
merkezenin fiziki altyapısı ve teknolojik donanımının
yenilenmiş olmasının mortaliteye olan etkisinin değerlendirilmesi
amaçlanmıştır.
Gereç ve Yöntem
Bu çalışmada Ocak-Aralık 2020 tarihleri arasında yanık
tedavi merkezine başvuran hastaların elektronik
kayıtları retrospektif olarak incelendi. Hastaların yaş,
cinsiyet, toplam vücut yanık yüzey alanı (TVYA%), yanık
derinliği, yanık yaralanma etiyolojisi, yatarak veya
ayaktan tedavi gereksinimi, inhalasyon hasarı varlığı,
hastane yatış gün sayısı, yoğun bakım yatış gün sayısı,
ABSI skoru ve mortalite verileri kaydedildi.
Bulgular
1 Ocak 2020 ile 31 Aralık 2020 tarihleri arasında yanık
merkezine toplam 1406 hasta başvurmuştur. Merkeze
başvuran 313 hastada (% 22,3) yanık tedavi algoritmasına
göre yatış endikasyonu mevcuttu. Yanık
etiyolojilerine göre yanıklar en sık haşlanma yanıkları
(%48,3) ve ikinci sıklıkla alev yanıkları (%14) idi.
Yatan hastaların TVYA ortalaması %12,6 iken genel
TVYA ortalaması %5,03 idi. Çalışmaya dahil edilen
1404 hastanın 16’sında (%1,2 ) mortalite gelişmişken
TVYA’sı %30 ve üzerinde olan hastaların 13’ünde
(%22) mortalite gerçekleşti. TVYA %30 ve üzerinde
olması ile mortalite arasında ilişki istatistiksel olarak
anlamlı bulundu (p<0,05).
Sonuç
Bu çalışmada yaklaşık 50 yıl hizmet veren bir yanık
tedavi merkezinin yeni ve modern bir hastane kompleksi
içine taşınmasından sonraki bir yıl içerisinde,
merkeze başvuran %30 ve üzerinde yanığı olan hastalarda
gerçekleşen mortalite oranının önceki senelere
göre daha düşük olduğu görülmüştür. Bu da mortalite
oranlarını iyileştirmek için uzmanlaşmış yanık
merkezi olmanın tek başına yeterli olmadığını aynı
zamanda iyileştirilmiş fiziksel koşullar ve gelişmiş teknolojik
ekipman altyapısına sahip olmanın da oldukça
önemli olduğunu göstermektedir.

Supporting Institution

Yok

Project Number

Yok

Thanks

İstatistiksel analizlere katkı sağlayan Sayın Okan Erkmen'e teşekkür ederiz

References

  • 1. Gupta JL, Makhija LK, Bajaj SP. National programme for prevention of burn injuries. Indian J Plast Surg 2010;43: S6–10.
  • 2. Kumar S, Ali W, Verma AK, Pandey A, Rathore S. Epidemiology and mortality of burns in the Lucknow Region, India-A 5 year study. Burns 2013;39:1599-605.
  • 3. WHO, 2018, Burn, Fact sheets. http://www.who.int/news-room/ fact-sheets/detail/burns. Accessed August 22, 2020.
  • 4. World Health Organization Geneva. Burns fact-sheets. 2018. [Accessed January 2018] http://www.who.int/news-room/ fact- sheets/detail/burns.
  • 5. Iqbal T, Saaiq M, Ali Z. Epidemiology and outcome of burns: Early experience at the country's first national burns Centre. Burns 2013;39:358-62.
  • 6. Gurbuz K, Demir M, Das K. The Use of Dermal Substitute in Deep Burns of Functional/Mobile Anatomic Areas at Acute Phase After Early Excision and Subsequent Skin Autografting: Dermal Substitute Prevents Functional Limitations. J Burn Care Res. 2020 Sep 23;41(5):1079-1083. doi: 10.1093/jbcr/iraa047. PMID: 32198511.
  • 7. Tripathee S, Basnet SJ, Epidemiology and outcome of hospitalized burns patients in tertiary care center in Nepal: Two year retrospective study. Burns Open 2017;1:16-19.
  • 8. Palmieri TL, Przkora R, Meyer WJ 3rd, Carrougher GJ. Measuring burn injury outcomes. Surg Clin North Am. 2014 Aug;94(4):909-16. doi: 10.1016/j.suc.2014.05.010. PMID: 25085096.
  • 9. Greenhalgh DG, Saffle JR, Holmes JH. American Burn Association Consensus Conferance to define sepsis and infection in burns. J Burn Care Res 2007; 28: 776-90.
  • 10. Yastı AÇ, Şenel E, Saydam M, Özok G, Çoruh A, Yorgancı K. Guideline and treatment algorithm for burn injuries. Ulus Travma Acil Cerrahi Derg. 2015 Mar;21(2):79-89. doi: 10.5505/tjtes. 2015.88261. PMID: 25904267.
  • 11. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the baux score. J Trauma. 2010 Mar;68(3):690-7. doi: 10.1097/ TA.0b013e3181c453b3. PMID: 20038856.
  • 12. Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med. 1982 May;11(5):260-2. doi: 10.1016/s0196-0644(82)80096-6. PMID: 7073049.
  • 13. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998 Feb 5;338(6):362-6. doi: 10.1056/NEJM199802053380604. PMID: 9449729.
  • 14. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998 Feb 5;338(6):362-6. doi: 10.1056/NEJM199802053380604. PMID: 9449729.
  • 15. Guldoğan CE, Kendirci M, Gundoğdu E, Yastı AC. Analysis of factors associated with mortality in major burn patients. Turk J Surg 2019; 35 (3): 155-164.
  • 16. Albayrak Y, Temiz A, Albayrak A, Peksöz R, Albayrak F, Tanrıkulu Y. A retrospective analysis of 2713 hospitalized burn patients in a burns center in Turkey. Ulus Travma Acil Cerrahi Derg 2018;24:25-30
  • 17. Brusselaers N, Juhász I, Erdei I, Monstrey S, Blot S. Evaluation of mortality following severe burns injury in Hungary: external validation of a prediction model developed on Belgian burn data. Burns. 2009 Nov;35(7):1009-14. doi: 10.1016/j.burns. 2008.12.017. Epub 2009 Jun 6. PMID: 19501970.
  • 18. Coruh A, Gunay GK, Esmaoglu A. A seven-year burn unit experience in Kayseri, Turkey: 1996 to 2002. J Burn Care Rehabil. 2005 Jan-Feb;26(1):79-84. doi: 10.1097/01. bcr.0000150301.80601.95. PMID: 15640740.

THE EFFECTS OF PHYSICAL STRUCTURE AND SYSTEM CHANGE IN THE BURN CENTER ON PATIENT OUTCOMES

Year 2021, Volume: 28 Issue: 3, 473 - 478, 13.09.2021
https://doi.org/10.17343/sdutfd.966455

Abstract

Objective
Burn injuries are the fourth most common injury
worldwide. There are significant differences in
burn demographics and results between different
geographical regions of the world, depending on sociocultural
factors, development and industrialization
levels. In this study, it was aimed to evaluate the
effect of renewing the physical infrastructure and
technological equipment of the burn treatment center
on mortality in patients with severe burns.
Materials and Methods
In this study, electronic records of patients admitted
to a burn treatment center between January and
December 2020 were retrospectively analyzed.
Patients' age, gender, total body burn surface area
(TBSA%), burn depth, burn injury etiology, presence
of inhalation injury, hospialization, number of
hospitalization days, number of intensive care unit
stays, ABSI score and mortality data were recorded.
Results
A total of 1406 patients applied to the center
between January 1, 2020 and December 31, 2020.
Hospitalization was indicated according to the burn
treatment algorithm in 313 patients (22.3%) who
applied to the center. According to burn etiologies,
the most common burns were scalding burns (48.3%)
and the second most frequent was flame burns
(14%). While the mean TBSA of hospitalized patients
was 12.6%, the overall mean TBSA was 5.03%. While
mortality developed in 16 (1.2%) of 1404 patients
included in the study, mortality occurred in 13 (22%)
patients with a TBSA of 30% or more. A statistically
significant correlation was found between a TBSA of
30% and above and mortality (p<0.05).
Discussion
In this study, it was observed that the mortality rate
in patients with burns of 30% or more who applied
to the center within one year after the burn treatment
center, which had been in service for 50 years, was
moved to a new and modern hospital complex, was
lower than in previous years. This shows that it is
not enough to be a specialized burn center alone to
improve mortality rates, but it is also very important
to have improved physical conditions and advanced
technological equipment infrastructure.

Project Number

Yok

References

  • 1. Gupta JL, Makhija LK, Bajaj SP. National programme for prevention of burn injuries. Indian J Plast Surg 2010;43: S6–10.
  • 2. Kumar S, Ali W, Verma AK, Pandey A, Rathore S. Epidemiology and mortality of burns in the Lucknow Region, India-A 5 year study. Burns 2013;39:1599-605.
  • 3. WHO, 2018, Burn, Fact sheets. http://www.who.int/news-room/ fact-sheets/detail/burns. Accessed August 22, 2020.
  • 4. World Health Organization Geneva. Burns fact-sheets. 2018. [Accessed January 2018] http://www.who.int/news-room/ fact- sheets/detail/burns.
  • 5. Iqbal T, Saaiq M, Ali Z. Epidemiology and outcome of burns: Early experience at the country's first national burns Centre. Burns 2013;39:358-62.
  • 6. Gurbuz K, Demir M, Das K. The Use of Dermal Substitute in Deep Burns of Functional/Mobile Anatomic Areas at Acute Phase After Early Excision and Subsequent Skin Autografting: Dermal Substitute Prevents Functional Limitations. J Burn Care Res. 2020 Sep 23;41(5):1079-1083. doi: 10.1093/jbcr/iraa047. PMID: 32198511.
  • 7. Tripathee S, Basnet SJ, Epidemiology and outcome of hospitalized burns patients in tertiary care center in Nepal: Two year retrospective study. Burns Open 2017;1:16-19.
  • 8. Palmieri TL, Przkora R, Meyer WJ 3rd, Carrougher GJ. Measuring burn injury outcomes. Surg Clin North Am. 2014 Aug;94(4):909-16. doi: 10.1016/j.suc.2014.05.010. PMID: 25085096.
  • 9. Greenhalgh DG, Saffle JR, Holmes JH. American Burn Association Consensus Conferance to define sepsis and infection in burns. J Burn Care Res 2007; 28: 776-90.
  • 10. Yastı AÇ, Şenel E, Saydam M, Özok G, Çoruh A, Yorgancı K. Guideline and treatment algorithm for burn injuries. Ulus Travma Acil Cerrahi Derg. 2015 Mar;21(2):79-89. doi: 10.5505/tjtes. 2015.88261. PMID: 25904267.
  • 11. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the baux score. J Trauma. 2010 Mar;68(3):690-7. doi: 10.1097/ TA.0b013e3181c453b3. PMID: 20038856.
  • 12. Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med. 1982 May;11(5):260-2. doi: 10.1016/s0196-0644(82)80096-6. PMID: 7073049.
  • 13. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998 Feb 5;338(6):362-6. doi: 10.1056/NEJM199802053380604. PMID: 9449729.
  • 14. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998 Feb 5;338(6):362-6. doi: 10.1056/NEJM199802053380604. PMID: 9449729.
  • 15. Guldoğan CE, Kendirci M, Gundoğdu E, Yastı AC. Analysis of factors associated with mortality in major burn patients. Turk J Surg 2019; 35 (3): 155-164.
  • 16. Albayrak Y, Temiz A, Albayrak A, Peksöz R, Albayrak F, Tanrıkulu Y. A retrospective analysis of 2713 hospitalized burn patients in a burns center in Turkey. Ulus Travma Acil Cerrahi Derg 2018;24:25-30
  • 17. Brusselaers N, Juhász I, Erdei I, Monstrey S, Blot S. Evaluation of mortality following severe burns injury in Hungary: external validation of a prediction model developed on Belgian burn data. Burns. 2009 Nov;35(7):1009-14. doi: 10.1016/j.burns. 2008.12.017. Epub 2009 Jun 6. PMID: 19501970.
  • 18. Coruh A, Gunay GK, Esmaoglu A. A seven-year burn unit experience in Kayseri, Turkey: 1996 to 2002. J Burn Care Rehabil. 2005 Jan-Feb;26(1):79-84. doi: 10.1097/01. bcr.0000150301.80601.95. PMID: 15640740.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Research Articles
Authors

Merve Akın 0000-0001-7224-4774

Ali Emre Akgün 0000-0002-0389-4922

Günel Garalova 0000-0002-4507-3962

Project Number Yok
Publication Date September 13, 2021
Submission Date July 8, 2021
Acceptance Date July 26, 2021
Published in Issue Year 2021 Volume: 28 Issue: 3

Cite

Vancouver Akın M, Akgün AE, Garalova G. YANIK MERKEZİNDE FİZİKİ YAPI VE SİSTEM DEĞİŞİKLİĞİNİN HASTA ÇIKTILARINA ETKİLERİ. Med J SDU. 2021;28(3):473-8.

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