Evaluation of fatal trauma cases presented to the emergency room

Öz

Objective: The aim of this study was to investigate the demographic and clinical characteristics of fatal trauma cases presenting to the Emergency Department of XXX Training and Research Hospital in Turkey. Methods: In this retrospective study, the forensic cases of fatal trauma patients admitted to the emergency department between 15.06.2017 and 15.06.2019 were obtained from the hospital's automation system, and the patient files and hospital police records were evaluated. Results: The most common cause of forensic trauma cases was pedestrian accidents (n=18; 25%), and the least common cause was crush injuries by a heavy object (n=2; 2.8%). The most common site of trauma was the cranial region (n=45; 62.5%). Forty-six patients died (63.9%) in the emergency room and 26 (36.1%) at various clinics. The average duration of active dying was 3.7 ± 17.9 hours. Fifty-four cases (75%) were found to be ethanol-negative and 18 (25%) were ethanol-positive. Conclusion: The most common forensic trauma cases are pedestrian accidents and seen in male patients. Most of these patients die in the emergency room, where they are first admitted. The most important factor in reducing mortality is preventing the occurrence of trauma. In addition to giving the person adequate and appropriate treatment, physicians also have the responsibility of writing clear and intelligible forensic reports in accordance with the laws and hospital rules.

Anahtar Kelimeler

• emergency,forensic case,death

Kaynakça

1. Referans1 Adli Tıp Uzmanları Derneği Birinci Basamak İçin Adli Tıp El Kitabı. Türk Tabipleri Birligi Merkez Konseyi. 1999;83–5. Referans2 Beyaztaş FY. Adli Rapor Konusunda Hekim Sorumluluğu. Anadolu Psikiyatri Dergisi. 2000;1:231-4. Referans3 Birinci Basamak İçin Adli Tıp El Kitabı. Adli Tıp Uzmanları Derneği-TTB. Ankara: Polat Matbaası. 1999;14-115. Referans4 Brunett PH, Cameron PA. Trauma. In: Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Cydulka RK, Meckler GD, editors. Tintinalli’s Emergency Medicine. A Compre- Hensive Study Guide. 7th ed. New York: Mc Graw Hill; 2011.p.1671-6. Referans5 Death Statics’’ in Turkish Statistical Institute. http://www.tuik.gov.tr/PreHaberBultenleri.doid=15847. Accessed 19 September 2013 Referans6 Trunkey DD. Trauma. Accidental and İntentional İnjuries Account For More Years of Life Lost İn The U.S. Than Cancer And Heart Disease. Among the Prescribed Remedies are İmproved Preventive Efforts, Speedier Surgery And Further Research. Sci Am 1983;249:28-35. Referans7 Ateşçelik M, Gürger M. Acil Servise Künt Travma ile Başvuran Hastaların İncelenmesi. Firat Med J 2013;18:103-108. Referans8 Ateşçelik M, Gürger M. Acil Servise Penetran Travma ile Başvuran Hastaların İncelenmesi. Konuralp Tıp Dergisi 2014;6:40-46. Referans9 Lyn-Sue J, Siram S, Williams D, Mezghebe H. Epidemiology of Trauma Deaths in an Urban Level-i Trauma Center Predominantly among African Americans Implications for Prevention. J Natl Med Assoc 2006;98:12. Referans10 Avcı S, Arslan ED, Büyükçam F. Acil Serviste Travmatik Ölümlerin Retrospektif Değerlendirilmesi Sakarya tıp dergisi 2017;7(1):15-19 Referans11 Angela S, Frederick MA, Ernest ME, Kathe MS, Regina BRN, Readrobert A et al. Epidemiology of Trauma Deaths: A Reassessment. J Trauma 1995;38(2):185-93. Referans12 Cothren CC, Moore EE, Hedegaard HB, Meng K. Epidemiology of Urban Trauma Deaths: A Comprehensive Reassessment 10 years later. World J Surg 2007;31(7):1507-11. Referans13 Varol O, Eren H, Oğuztürk H, Korkmaz İ, Beydilli İ, ‟Acil Servise Trafik Kazası Sonucu Başvuran Hastaların İncelenmesi”. Cumhuriyet Üniversitesi Tıp Fakültesi Dergisi, 2006;28(2):55-60. Referans14 Trajano AD, Pereira BM, Fraga GP. Epidemiology of in-Hospital Trauma Deaths in a Brazilian University Hospital. BMC Emerg Med 2014; 14:22. Referans15 Seviner M, Kozacı N, Ay MO, Açikalın A, Çökük A, Gülen M, Acehan S, Karanlık M, Satar S, Acil Tıp Kliniğine Başvuran Adli Vakaların Geriye Dönük Analizi Cukurova Medical Journal 2013; 38 (2):250-260. Referans16 Yavuz MS, Özgüner IF. Süleyman Demirel Üniversitesi Tıp Fakültesi Acil Servisi'ne 1999-2001 Yılları Arasında Müracaat Eden Adli Olguların Değerlendirilmesi. Adli Tıp Dergisi. 2003; 17: 47-5. Referans17 Güven FMK, Bütün C, Beyaztaş Y, Eren ŞH, Korkmaz İ. Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesine Başvuran Adli Olguların Değerlendirilmesi. ADÜ Tıp Fakültesi Dergisi. 2009; 10: 23-8. Referans18 Türkmen N, Akgöz S, Çoltu A, Ergin N. Uludağ Üniversitesi Tıp Fakültesi Acil Servisine Başvuran Adli Olguların Değerlendirilmesi. Uludağ üniversitesi tıp fakültesi dergisi. 2005; 31: 25-9. Referans19 Arslan ED, Kaya E, Sönmez M, Kavalcı C, Solakoğlu A, Yılmaz F et al. Assesment of Traumatic Deaths in a Level One Trauma Center in Ankara, Turkey. Eur J Trauma Emerg Surg 2015;41(3):319-23. Referans20 Evans JA, Wessem KJP, McDougall D, Lee KA, Lyons T, Balogh ZJ. Epidemiology of Traumatic Deaths: Comprehensive Population- Based Assessment. World J Surg 2010;34:158-163. Referans21 Gunst M, Ghaemmaghami V, Gruszecki A, Urban J, Frankel H, Shafi S. Changing Epidemiology of Trauma Deaths Leads to a Bimodal Distribution. Proc 2010;23(4):349–354. Referans22 Hamzeh B, Najafi F, Karamimatin B, Ahmadijouybari T, Salari A, Moradinazar M. Epidemiology of Traffic Crash Mortality in West of Iran in a 9 year period. Chinese J Traum 2016; 70–74. Referans23 Horwood LJ, Fergusson DM. Drink Driving And Traffic Accident İn Young People. Accident Analysis and Prevention 2000; 32: 805-814. Referans24 Baydın A, Yardan T, Guven H, Dervişoğlu A, Otal Y, Eden A, Karataş Ad Travmada Laktat, Baz Açığı Seviyesi ve Travma Ciddiyet Skoru’nun (Injury Severity Score) Mortalite ile İlişkisi Turk J Emerg Med 2007;7(3):97-101.