Forensic-medical retrospective analysis of cardiovascular injuries admitted to the emergency department

Yıl 2022, , 659 - 663, 15.03.2022

Bedirhan Sezer Öner , Ahmet Kağan As

https://doi.org/10.32322/jhsm.1073892

Öz

Aim: Vascular and cardiac injuries are rare cases compared to other traumas in terms of admission rates to emergency services. Vascular emergencies secondary to trauma are among 1-2.5% of all trauma patients admitted to the emergency department. In addition, the admission rate of heart injuries is around 1%. With this study, we will analyze and interpret cardio-vascular injuries, which are rare compared to other traumas, from a forensic-medical aspect.
Material and Method: This study is a retrospective cohort study using data from our hospital's automation and archive system. Patients who developed iatrogenic trauma, had solid organ injury in addition to their existing injury, were brought to the emergency room as deceased, and patients who came to the emergency room with cardio-pulmonary resuscitation were not included in the study. A total of 411 cases, 88 cardiac injuries and 323 vascular injuries, aged 16-82 years were included in the study.
Results: In the 5-year analysis, the rate of life-threatening injuries due to cardiac and vascular injuries among cardiovascular emergencies is 22%. 88 patients with cardiac injury were included in this study.18 (20.5%) of the patients were female and 70 (79.5%) were male. The most common injury sites were upper extremity (43.7%), lower extremity (25.7%), thorax (21.4%), abdomen-pelvic region (4.1%), head-neck (2.6%), multiple vascular injury (2.1%), respectively.
Conclusion: Cardiovascular injuries are among the traumas with high mortality and morbidity. It is important that the cases consulted to cardiovascular surgery in the emergency department are forensic cases and that the forensic reports of these cases are carefully prepared.

Anahtar Kelimeler

cardiac injury, vascular injury, emergency department, forensic Medicine

Kaynakça

• Fincancı SK. Adli olguya yaklaşım. Yeni yasalar çerçevesinde hekimlerin hukuki ve cezai sorumluluğu. Tıbbi Malpraktis ve Adli Raporların Düzenlenmesi Sempozyum Dizisi. Şubat 2006; 48: 92-103.
• Sever M, Ulaş ES, Koşargelir M. Bir üçüncü basamak hastane acil servisine başvuran adli nitelikli çocuk hastaların değerlendirilmesi. Ulus Travma Acil Cerrahi Derg 2010; 16: 260-7.
• Sugrue M, Caldwell EM, Damours SK, Crozier JA, Deane SA. Vascular injury in Australia. Surg Clin North Am 2002; 82: 211e9.
• Caps MT. The epidemiology of vascular trauma. Semin Vasc Surg 1998; 11: 227e31.
• Loh SA, Rockman CB, Chung C, et al. Existing trauma and critical care scoring systems underestimate mortality among vascular trauma patients. J Vasc Surg 2011; 53: 359-66.
• Perkins ZB, De'Ath HD, Aylwin C, Brohi K, Walsh M, Tai NRM. Epidemiology and outcome of vascular trauma at a British Major Trauma Centre. Eur J Vasc Endovasc Surg 2012; 44: 203-9.
• VanWaes OJ, Navsaria PH, Verschuren RC, et al. Management of penetrating injuries of the upper extremities. Ulus Travma Acil Cerrahi Derg 2013; 19: 405-10.
• Campbell NC, Thomson SR, Muckart DJ, Meumann CM, Van Middelkoop I, Botha JB. Review of 1198 cases of penetrating cardiac trauma. Br J Surg 1997; 84: 1737-40.
• Akay T. Kalp ve damar yaralanmaları. Toraks Cerrahisi Bülteni 2010; 1: 75-86.
• Arikan S, Yücel AF, Kocakuşak A, Dadük Y, Adaş G, Onal MA. Retrospective analysis of the patients with penetrating cardiac trauma. Ulus Travma Acil Cerrahi Derg 2003; 9: 124- 8.
• Felician DV, Moore EE, Biffl WL. Western trauma association critical decisions in trauma: management of abdominal vascular trauma. J Trauma Acute Care Surg 2015; 79: 1079-88.
• Altun G, Azmak D, Yılmaz A. Yaşayan olgularda kesici-delici alet yaralanmaları. Adli Tıp Bülteni 2000; 5: 52-5.
• Altundag MT, Ulucay T, Zeyfeloglu Y, et al. Izmir'de yapılmış mediko-legal otopsilerde büyük damar yaralanmaları saptanan olguların değerlendirilmesi. J For Med 2014;  28: 256-66.
• Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Acil servise başvuran adli olguların ve düzenlenen adli raporların değerlendirilmesi.  Med Bull Haseki2012; 50: 14‐20.
• Çetin Erdoğan Z, Teyin A, Birben B, Çetin B, Şahiner GG, Hamamcı M. Acil serviste düzenlenen adli raporların değerlendirilmesi. Bozok Med J 2018; 8: 34‐40.
• Altun G, Azmak AD, Yılmaz A, Yılmaz G. Trakya Üniversitesi Tıp Fakültesi Acil Servisi’ne başvuran adli olguların özellikleri. Adli Tıp Bülteni 1997; 2: 62‐6.
• Kaçmaz IE, Uzakgider M, Basa CD, et al. Retrospective analysis of adult forensic cases admitted to the emergency medicine clinic and consulted with orthopedics and traumatology. J DEU Med 2020; 34: 43-52.
• Ulucay T, Altundag MT, Yavuz MS, et al. Künt veya penetran kardiyak yaralanma sonucu ölümlerin retrospektif değerlendirilmesi, J For Med 2015; 29: 1-11.
• Manduz Ş, Katrancıoğlu N, Bingöl H, Atlı H, Doğan K. Delici kardiyak yaralanmalar. Turkish J Thorac Cardiovasc Surg 2008; 16: 228-31.
• Prichayudh S, Verananvattna A, Sriussadaporn S, et al. Management of upper extremity vascular injury: outcome related to the Mangled Extremity Severity Score. World J Surg 2009; 33: 857-63.