2011-2021 Yılları Arasında Acil Servise Fasiyal Kemiklerde Fraktür Sebebi ile Başvuran Hastaların Retrospektif Analizi

Year 2024, Volume: 50 Issue: 1, 35 - 40, 17.05.2024

Nihal Akçalı Bostancı , Vahide Aslıhan Durak , Sümeyye Tuğba Sarkı Cander , Halil İbrahim Çıkrıklar , Buşra Altınkök Şentürk , Orhan Çavdar

https://doi.org/10.32708/uutfd.1428054

Abstract

Bu çalışmada fasiyal yaralanma nedeniyle Acil Servise başvuran olguların klinik özellikleri ve klinik sonlanımları ile ilişkili parametrelerin belirlenmesi amaçlanmıştır. Kesitsel tipte olan bu çalışmada 2011-2021 yılları arasında Bursa Uludağ Üniversitesi Acil Servisine fasiyal yaralanma sebebi ile başvuran ve plastik ve rekonstrüktif cerrahi anabilim dalına fasiyal kemiklerde fraktür sebebi ile konsülte edilen hastaların klinik özellikleri hastane kayıtlarından retrospektif olarak taranmıştır. Olguların %80,5’i erkekti, en sık travma nedenleri %26,1 darp, %25,7 düşme ve %14,0 araç içi trafik kazasıydı. En sık başvuru yaz aylarında yapılmıştı (%34,5). En sık yaralanan fasiyal kemikler %43,6 nazal kemik, %32,4 maksilla ve %31,8 orbitaydı. Olguların %72,6’sı taburcu edilirken, %14,3’ü kliniğe, %4,8’i YBÜ’ye yatırıldı, %3,7’si sevk edildi ve %0,3’ü eksitus oldu. Kadınlarda ateşli silah yaralanması, yüksekten düşme ve trafik kazaları kaynaklı travmalara maruz kalan olgular arasında YBÜ’ye yatış/ eksitus sıklığı anlamlı düzeyde daha fazlaydı (p<0,05). Yaralanma saptanan fasiyal kemiğe göre YBÜ’ye yatış/ eksitus durumu sıklık sırasına göre şu şekildeydi: frontal (%19,0), orbita (%9,0), maksilla (%8,3), zigoma (%8,1), mandibula (%8,0) ve nazal (%3,6) kemik. Herhangi tipte fasiyal kemik fraktürü saptanması YBÜ’ye yatış/ eksitus ile ilişkili bulundu (p<0,05). Sonuç olarak fasiyal yaralanmalı olgular daha çok erkeklerden oluşmakta, yaz aylarında, darp ya da düşme kaynaklı nazal fraktürle acil servise başvuru yapmaktadır. Kadınlar, daha yüksek enerjili travmaya maruz kalanlar ve fasiyal kemik fraktürü saptananlar arasında klinik sonlanım daha olumsuz olmaktadır. Bu özelliklere sahip olguların daha sıkı takip edilmesi ve erken dönemde uygun tedavinin sağlanması sağkalım ve sekel sıklığını azaltacak müdahaleler arasında değerlendirilebilir.

Keywords

acil servis, fasiyal kemik fraktürü, travma

Retrospective Analysis of Patients Presenting to the Emergency Department between 2011-2021 with Fractures in the Facial Bones

Abstract

This study aimed to determine the parameters associated with the clinical characteristics and clinical outcomes of cases admitted to the Emergency Department due to facial injury. In this cross-sectional study, the clinical characteristics of the patients who applied to Bursa Uludag University Emergency Service due to facial injury between 2011 and 2021 and were consulted to the department of plastic and reconstructive surgery due to fractures in facial bones were retrospectively analyzed from hospital records. 80.5% of the cases were male, the most common causes of trauma were 26.1% assault, 25.7% fall and 14.0% in-car traffic accident. The most frequent application was made in the summer months (34.5%). The most frequently injured facial bones were the nasal bone in 43.6%, the maxilla in 32.4%, and the orbit in 31.8%. While 72.6% of the cases were discharged, 14.3% were admitted to the clinic, 4.8% were admitted to the ICU, 3.7% were referred and 0.3% died. The frequency of ICU admission/ ex was significantly higher among women who were exposed to trauma due to gunshot wounds, falling from heights, and traffic accidents (p<0.05). ICU admission/exit status according to the facial bone with injury was as follows, in order of frequency: frontal (19.0%), orbita (9.0%), maxilla (8.3%), zygoma (8.1%). mandibular (8.0%) and nasal (3.6%) bone. Detection of any type of facial bone fracture was found to be associated with ICU admission/exit (p<0.05). As a result, cases with facial injuries mostly consist of men, and they apply to the emergency department with nasal fractures caused by assault or falling in the summer months. Clinical outcome is worser among women, those exposed to higher energy trauma, and those diagnosed with facial bone fractures. Closer follow-up of cases with these characteristics and providing appropriate treatment in the early period can be considered among the interventions that will reduce survival and the frequency of sequelae.

Keywords

emergency department, facial bone fracture, trauma

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