Multipl kot kırıklarında pulmoner morbiditeyi tahmin etmede toraks travma skorlarının etkinliği

Öz

Amaç: Künt toraks travmalarına bağlı multipl kot kırıkları ciddi ağrıya neden olur, iyleşmesi uzun zaman alır ve hastanın morbidite ve mortalite riskleriyle yakından ilişkilidir. Çalışmamızda multipl kot kırığı olan hastalarda Torasik Travma Şiddet Skoru (TTSS), Göğüs Travma Skoru (CTS), Kot Kırığı Skoru (RFS) ve Kot Skorunun (Rs) hastane ve yoğun bakım yatış süresi, morbidite ve mortaliteyi tahmin etmedeki etkinliğini saptamayı amaçladık. Gereç ve Yöntem: Çalışmaya Ağustos 2020 ile Ağustos 2022 tarihleri arasında, künt travma sonucu multipl kot kırıkları nedeniyle kliniğimizde yatırılarak tedavi edilen 122 hasta dahil edildi. Hastaların yaş, cinsiyet, travma şekli, kot kırığı sayısı, pulmoner parankim ve plevral patolojiler, hastane ve yoğun bakım yatış süresi, pulmoner morbidite ve mortalite bilgileri hastane elektronik kayıt sistemi ve dosya arşivinden elde edildi. Hastane yatış süresi, yoğun bakım yatış süresi, pulmoner morbidite ve mortalite ile TTSS, CTS, RFS ve Rs arasındaki ilişki istatistiksel olarak değerlendirildi. Bulgular: TTSS ile yoğun bakımda yatış süresi, pulmoner morbidite ve mortalite arasında istatistiksel olarak anlamlı ilişki saptanırken, hastane yatış süresi ile arasında anlamlı ilişki saptanmadı. CTS ile hastane yatış süresi ve pulmoner morbidite arasında istatistiksel olarak anlamlı ilişki saptanırken, yoğun bakım yatış süresi ve mortalite ile arasında anlamlı ilişki saptanmadı. RFS ile pulmoner morbidite arasında istatistiksel olarak anlamlı ilişki saptanırken, hastanede yatış süresi, yoğun bakımda yatış süresi ve mortalite ile arasında anlamlı ilişki saptanmadı. Rs ile hastanede yatış süresi, yoğun bakımda yatış süresi, pulmoner morbidite ve mortalite arasında istatistiksel olarak anlamlı ilişki saptanmadı. Sonuç: Ciddi ekstratorasik yaralanması olmayan multipl kot kırığı hastalarında morbidite ve mortaliteyi tahmin etmede, hastanın yaşını ve pulmoner durumunu da skorlayan TTSS ve CTS’nin diğer toraks travma skorlamalarına göre daha etkin olduğu kanaatindeyiz.

Anahtar Kelimeler

• Kot kırığı
• travma
• Skor

Multipl kot kırıklarında pulmoner morbiditeyi tahmin etmede toraks travma skorlarının etkinliği

Öz

Multiple rib fractures due to blunt thoracic traumas cause severe pain, take a long time to heal, and are closely associated with serious morbidity and mortality risk. In our study, we aimed to determine the effectiveness of Thoracic Trauma Severity Score (TTSS), Chest Trauma Score (CTS), Rib Fracture Score (RFS) and Rib Score (Rs) in predicting hospital and intensive care hospital stay, morbidity and mortality in patients with multiple rib fractures. Between August 2020 and August 2022, 122 patients hospitalized in our clinic for multiple rib fractures as a result of blunt trauma were included in the study. Patients' age, gender, trauma type, number of rib fractures, pulmonary parenchyma and pleural pathologies, hospital and intensive care unit length of stay, pulmonary morbidity and mortality were obtained from the hospital electronic record system and file archive. The relationship between length of hospital stay, length of stay in intensive care unit, pulmonary morbidity and mortality with TTSS, CTS, RFS and Rs were evaluated statistically. While there was a statistically significant relationship between TTSS and the length of stay in the intensive care unit, pulmonary morbidity and mortality, no significant relationship was found between the length of hospital stay. While a statistically significant relationship was found between CTS and hospitalization time and pulmonary morbidity, no significant relationship was found between intensive care unit length of stay and mortality. While a statistically significant relationship was found between RFS and pulmonary morbidity, no significant relationship was found between length of hospital stay, length of stay in the intensive care unit, and mortality. No statistically significant correlation was found between Rs and length of hospital stay, length of stay in the intensive care unit, pulmonary morbidity and mortality. We believe that TTSS and CTS, which also score the patient's age and pulmonary status, are more effective than other thorax trauma scoring systems in predicting morbidity and mortality in patients with multiple rib fractures without serious extrathoracic injury.

Anahtar Kelimeler

• Rib fracture
• Trauma
• Skore

Kaynakça

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