Analysis of patients consulted to the neurosurgery clinic from the emergency department and evaluation of mortality

Yıl 2024, Cilt: 4 Sayı: 2, 40 - 47, 22.08.2024

Mustafa Alpaslan , Sultan Özselçuk

https://doi.org/10.58961/hmj.1501247

Öz

ABSTRACT
Objective: To analyze neurosurgical consultations in emergency department admissions, to reveal the characteristics of patients in need of neurosurgery and to analyze mortality in patients.
Materials and Methods: The study was conducted retrospectively in the emergency department of a secondary care hospital. All patients consulted to the neurosurgery clinic from the adult emergency department between 01.01.2023-31.12.2023 were evaluated in the study. Demographic data, admission and/or admission complaint, diagnosis, comorbid disease status, anticoagulant use, surgical procedure status, Glasgow Coma Score at the time of arrival to the emergency department, duration of hospitalization and in-hospital mortality status were analyzed.
Results: 595 patients were evaluated in the study. 59.5% of the patients were male and the mean age was 45.17±25.77 years. The most common type of admission was general body trauma due to fall (48.9%). The most common diagnosis was isolated lumbar vertebral fracture (15%). Intensive care unit hospitalization, surgical procedures and mortality rates were significantly higher in patients with a lower Glasgow Coma Score at admission (p<0.05). Anticoagulant use was significantly higher in patients with intracranial hemorrhage (p=0.006). The length of hospitalization was significantly higher in patients with cranial hemorrhage compared to other cases (p=0.000). Surgical procedures were performed in 9.4% of the patients (n=56). In total, 45 patients died (7.6%), including three in the emergency department. Conclusion: Neurosurgical consultations are extremely important in the emergency department and the majority of patients with pathology were found to be at risk for morbidity and mortality due to intracranial hemorrhage and spinal cord injury.

Anahtar Kelimeler

Emergency Department, Neurosurgery, Head Trauma, Spinal Cord Injury, Mortality

Acil servisten nöroşirurji kliniğine konsülte edilen hastaların analizi ve mortalitenin değerlendirilmesi

Öz

ÖZET
Amaç: Acil servis başvuruları içerisindeki nöroşirürji konsültasyonlarını analiz ederek nöroşirürji ihtiyacı olan hastaların özelliklerinin ortaya konulması ve hastalarda mortalite analizinin yapılmasıdır.
Gereç ve Yöntem: Çalışma retrospektif olarak ikinci basamak bir hastanenin acil servisinde yapılmıştır. Çalışmada 01.01.2023-31.12.2023 tarihleri arasında erişkin acil servisten nöroşirurji kliniğine konsülte edilen tüm hastalar değerlendirildi. Hastalarda demografik veriler, başvuru ve/veya kabul şikâyeti, teşhis, komorbit hastalık durumu, antikoagülan kullanımı, cerrahi işlem durumu, acil servise geliş anındaki Glaskow Koma Skoru, hastanede yatış süresi ve hastane içi mortalite durumu analiz edildi.
Bulgular: Çalışmada 595 hasta değerlendirildi. Hastaların % 59,5’i erkeklerden oluşmakta olup yaş ortalaması 45,17±25,77 oldu. Hastalarda en sık görülen kabul şekli düşmeye bağlı genel vücut travması (%48,9) oldu. Hastalarda konulan teşhislere bakıldığında en sık izole lomber vertebra fraktürü (%15) olduğu görüldü. Kabul anında Glaskow Koma Skoru düşük olanlarda yoğun bakım yatışı, cerrahi işlem yapılma ve mortalite oranı anlamlı derecede daha yüksekti (p<0,05). Antikoagülan kullanımının intrakranyal kanama olanlarda anlamlı oranda yüksek olduğu görüldü (p=0,006). Kranyal kanama olana hastaların yatış süresi diğer vakalara göre anlamlı oranda daha yüksekti (p=0,000). Hastaların %9,4’üne (n=56) cerrahi işlem yapıldı. Toplamda acil serviste üç olmak üzere 45 hasta ölümle (% 7,6) sonlandı. Sonuç: Nöroşirurji konsültasyonları acil servis açısından son derece önemli olup patoloji saptanan hastaların büyük çoğunluğunun intrakranyal kanama ile spinal kord yaralanması gibi durumlara bağlı olarak morbidite ve mortalite açısından riskli hastalar olduğu görüldü.

Anahtar Kelimeler

Acil Servis, Nöroşiruji, Kafa Travması, Spinal Kord Yaralanması, Mortalite

Kaynakça

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