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EVALUATION OF FORENSIC CASES ASSOCIATED WITH NEUROCHIRURGY ADMITTED TO EMERGENCY CLINIC

Yıl 2019, , 1214 - 1221, 15.04.2019
https://doi.org/10.30569/adiyamansaglik.500984

Öz

Introduction: Forensic
cases consist of medical cases associated with several distinct medical
departments, and meticulous examination and recording should be “sine qua non”
part of the management. We aimed to analyze the files of forensic cases in
neurochirurgy clinics, evaluate these files by the view of forensic medicine,
and to emphasize the importance of meticulous medical recordings.

Materials and Methods: Patients
admitted to the neurosurgery clinic from the emergency department, motor
vehicle accidents, motorcycle accidents, work accidents, hanging cases, assault
or chemical injuries were included in the study. The electronic files,
radiographs, computed tomography and magnetic resonance imaging recordings of
the patients were analyzed and compared with patient cart. Age, gender, the
causes of the events, and the number of autopsy were recorded. The patients
were grouped according to gender, the admission ward (intensive care unit (ICU)
or service), and the cause of the admission of the patient. Non-forensic cases;
for example, patients with degenerative disc herniation, spontaneous cerebral
hemorrhage or cerebral tumor were excluded.

Results: A total of 275 patients with
suitable criteria, were included in the study. Of total, 249 (90,54%) patients
were in alive, 26 (9,46%) in exitus group. 12.9% and 7.7% of the patients were
female in alive and exitus groups, respectively (p=0.753). All the patients in
chemical injury, hanging and work accident groups were male. The ratio of
admission to ICU was 99.6% and 100% in alive and exitus groups, respectively.
The most frequent cause of admission was traffic accident in both groups;
however, there was significant difference between groups according to cause of
admission (p=0.002).

When comparing to traffic accident group, the
mortality rate was 6.2 times higher in motorcycle accident, and it was 6.8
times higher in hanging group.









Conclusion:
We found that the most
frequent cause of admission was traffic accident both in alive and exitus
groups. However, the mortality rate of hanging and motorcycle accident was
higher than motor vehicle accident. This finding helps us to evaluate which
forensic cases necessitate acute medical management in emergency ward.
For the forensic cases
concerning to neurochirurgy, the specialists of neurochirurgy should be in
contact with the emergency clinic team.
At the same time, we also believe that accurate
medical records of forensic cases related to neurosurgery will contribute to
the correct and rapid management of the judicial process.

Kaynakça

  • 1- Özer E, Gümüş B, Balandiz H, Kırcı GS, Aydoğdu Hİ, Tetikçok R. Evaluation of geriatric suicides in Turkey. J Forensic Leg Med. 2016;44:158-161.
  • 2- Timur O, Tasar PT, Ulusoy MG, Irez A, Yildirim F, Binici DN, Sahin S, Kok AN. Autopsies in the elderly: Erzurum study. J Forensic Leg Med. 2017;52:143-147. 3- Bhosle SH, Zanjad NP, Dake MD, Godbole HV. Deaths due to hanging among adolescents - A 10-year retrospective study.J Forensic Leg Med. 2015;29:30-3.
  • 4- Buschmann CT, Kleber C, Tsokos M, Püschel K, Hess T, Kerner T, Stuhr M. Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures. Anasthesiol Intensivmed Notfallmed Schmerzther. 2015;50(6):392-9.
  • 5- Szeremeta M, Niemcunowicz-Janica A, Sackiewicz A, Ptaszyńska-Sarosiek I. [Analysis of traffic accident fatalities in autopsy material collected in the years 2007-2008 at the Department of Forensic Medicine, Medical University of Białystok].Arch Med Sadowej Kryminol. 2009;59(3):172-6.
  • 6- Calosevic S, Lovric Z. Prognostic significance of specific injury patterns in casualties of traffic-related accidents. Injury. 2015;46(6):27-30.
  • 7- Kłys M, Grzeszczuk S, Majchrzak T. Fatal traffic accidents vs. alcohol consumption in the victims in the archival material collected by the Institute of Forensic Medicine, Collegium Medicum, Jagiellonian University in Cracow, in the years 2000- 2003. Arch Med Sadowej Kryminol. 2006;56(2):80-5.
  • 8- Barbería E, Suelves JM, Xifró A, Medallo J. [Differences between immediate and 30-day deaths due to traffic injuries according to forensic sources]. Gac Sanit. 2015;29 (1):66-9.
  • 9- Hellier C, Connolly R.Cause of death in judicial hanging: a review and case study.Med Sci Law. 2009;49(1):18-26.
  • 10- Kumral B, Ozdes T, Avsar A, Buyuk Y.Accidental deaths by hanging among children in Istanbul, Turkey: retrospective analysis of medicolegal autopsies in 33 years.Am J Forensic Med Pathol. 2014;35(4):271-4.
  • 11- Reijnders UJ, Giannakopoulos GF, de Bruin KH. Assessment of abuse-related injuries: a comparative study of forensic physicians, emergency room physicians, emergency room nurses and medical students. J Forensic Leg Med. 2008;15 (1):15-9.

EVALUATION OF FORENSIC CASES ASSOCIATED WITH NEUROCHIRURGY ADMITTED TO EMERGENCY CLINIC

Yıl 2019, , 1214 - 1221, 15.04.2019
https://doi.org/10.30569/adiyamansaglik.500984

Öz

Giriş: Adli vakalar, çeşitli
medikal departmanlar ile ilişkili vakaları kapsamaktadır ve bu vakaların
yönetiminde titiz bir muayene ve kayıt sistemi yönetimin olmazsa olmaz
parçasıdır. Biz çalışmamızda, beyin cerrahisi kliniğindeki adli vaka
dosyalarını analiz etmeyi, bu dosyaları adli tıp bakışıyla değerlendirmeyi ve
titiz bir medical kayıt tutma işleminin önemini vurgulamayı amaçladık.

Gereç ve Yöntem: Acil servisten  beyin cerrahi kliniğine kabul edilen motorlu
araç kazaları, motosiklet kazaları, iş kazaları, ası olguları, darp  veya kimyasal yaralanma ile başvuran hastalar
çalışmaya alındı. Hastaların elektronik dosyaları, manyetik rezonans ve
bilgisayarlı tomografi görüntüleri ve radyografileri değerlendirildi ve epikriz
ile karşılaştırıldı. Yaş, cinsiyet, başvuru sebebi ve otopsi sayısı kaydedildi.
Hastalar cinsiyet, yatış sebebi ve yatış yerine (yoğun bakım veya servis) gore
gruplara ayrıldı.  Adli olmayan olgular;
örneğin dejeneratif disk hernisi olan, spontan serebral kanaması olan veya
serebral tümörü olan hastalar dışlandı.

Bulgular:
Kriterlere
uygun olan toplamda 275 hasta çalışmaya dahil edildi. Olgular yaşayan 249
(%90,54)  hasta ve 26 (%9,46) olgu eksitus
olarak grulandırıldı. Yaşayan ve eksitus grubunda kadın hasta oranı %12.9 ve
%7.7 saptandı (p=0.753). Kimyasal ve iş kazası ve ası grubundaki hastaların
tamamının erkek olduğu tespit edildi. Yaşayan ve eksitus gruplarında yoğun
bakıma yatış oranı sırasıyla %99.6 ve %100’dü. İki grupta da yatışın en sık
sebebi trafik kazasıydı; ancak, yatış sebepleri açısından anlamlı farklılık
mevcuttu (p=0.002). Trafik kazasıyla diğer gruplar karşılaştırıldığında,
mortalite oranı motorsiklet kazası grubunda 6.2 kat, ası grubunda 6.8 kat
yüksek olduğu belirlendi.







Sonuç: Yaşayan
ve eksitus gruplarında trafik kazası en sık başvuru sebebi olarak saptandı. Ancak,
motorsiklet kazası ve ası grubunda mortalite oranı trafik kazası grubundan daha
yüksek olduğu tespit edildi. Bu bulgular bize, hangi adli vakaların akut medikal
tedavi gereksinimi olduğu konusunda ön fikir vermede yardımcı olabilir.
Nöroşirurjiyi ilgilendiren adli vakalar için, nöroşirurji uzmanları acil
kliniği ekibiyle temas halinde olmalıdır. Aynı zamanda, nöroşirurji ile ilgili
adli vakaların medical kayıtlarının doğru tutulmasının adli sürecin doğru ve
hızlı yönetilmesine katkı sağlayacağı kanaatindeyiz.

Kaynakça

  • 1- Özer E, Gümüş B, Balandiz H, Kırcı GS, Aydoğdu Hİ, Tetikçok R. Evaluation of geriatric suicides in Turkey. J Forensic Leg Med. 2016;44:158-161.
  • 2- Timur O, Tasar PT, Ulusoy MG, Irez A, Yildirim F, Binici DN, Sahin S, Kok AN. Autopsies in the elderly: Erzurum study. J Forensic Leg Med. 2017;52:143-147. 3- Bhosle SH, Zanjad NP, Dake MD, Godbole HV. Deaths due to hanging among adolescents - A 10-year retrospective study.J Forensic Leg Med. 2015;29:30-3.
  • 4- Buschmann CT, Kleber C, Tsokos M, Püschel K, Hess T, Kerner T, Stuhr M. Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures. Anasthesiol Intensivmed Notfallmed Schmerzther. 2015;50(6):392-9.
  • 5- Szeremeta M, Niemcunowicz-Janica A, Sackiewicz A, Ptaszyńska-Sarosiek I. [Analysis of traffic accident fatalities in autopsy material collected in the years 2007-2008 at the Department of Forensic Medicine, Medical University of Białystok].Arch Med Sadowej Kryminol. 2009;59(3):172-6.
  • 6- Calosevic S, Lovric Z. Prognostic significance of specific injury patterns in casualties of traffic-related accidents. Injury. 2015;46(6):27-30.
  • 7- Kłys M, Grzeszczuk S, Majchrzak T. Fatal traffic accidents vs. alcohol consumption in the victims in the archival material collected by the Institute of Forensic Medicine, Collegium Medicum, Jagiellonian University in Cracow, in the years 2000- 2003. Arch Med Sadowej Kryminol. 2006;56(2):80-5.
  • 8- Barbería E, Suelves JM, Xifró A, Medallo J. [Differences between immediate and 30-day deaths due to traffic injuries according to forensic sources]. Gac Sanit. 2015;29 (1):66-9.
  • 9- Hellier C, Connolly R.Cause of death in judicial hanging: a review and case study.Med Sci Law. 2009;49(1):18-26.
  • 10- Kumral B, Ozdes T, Avsar A, Buyuk Y.Accidental deaths by hanging among children in Istanbul, Turkey: retrospective analysis of medicolegal autopsies in 33 years.Am J Forensic Med Pathol. 2014;35(4):271-4.
  • 11- Reijnders UJ, Giannakopoulos GF, de Bruin KH. Assessment of abuse-related injuries: a comparative study of forensic physicians, emergency room physicians, emergency room nurses and medical students. J Forensic Leg Med. 2008;15 (1):15-9.
Toplam 10 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Şeyho Cem Yücetaş 0000-0002-2891-1805

Hüseyin Kafadar 0000-0002-6844-7517

Yayımlanma Tarihi 15 Nisan 2019
Gönderilme Tarihi 22 Aralık 2018
Kabul Tarihi 31 Ocak 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

AMA Yücetaş ŞC, Kafadar H. EVALUATION OF FORENSIC CASES ASSOCIATED WITH NEUROCHIRURGY ADMITTED TO EMERGENCY CLINIC. ADYÜ Sağlık Bilimleri Derg. Nisan 2019;5(1):1214-1221. doi:10.30569/adiyamansaglik.500984