Araştırma Makalesi
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Koronavirüs-19 Pandemi Dönemi Kısıtlamalarının Geriatrik Hasta Grubunda Kafa ve Spinal Travma Sayıları Üzerine Etkisi

Yıl 2023, Cilt: 18 Sayı: 2, 93 - 98, 12.07.2023
https://doi.org/10.17517/ksutfd.1208380

Öz

Amaç: Osteoporoz ve sedatif yaşam nedeniyle geriatrik hastalar travma sonrası yaralanmaya daha açıktırlar. Özellikle düşme sonrası kafa travması ve spinal
kemik kırıkları oluşmaktadır. Koronavirüs-19 (Covid-19) pandemisi döneminde ülkemizde alınan önlemlerden ilki 65 yaş ve üzeri sokağa çıkma kısıtlaması
olmuştur. Bu çalışmanın amacı sokağa çıkma kısıtlaması olan 21 mart-3 haziran 2020 tarihleri arasında evlerinde kalmak zorunda olan 65 yaş ve üzeri yaş
grubunda bir önceki yıla göre kafa travması ve spinal travma sayılarının değişimini değerlendirmektir.
Gereç ve Yöntemler: Kafa ve omurga travması nedeniyle şehrimizdeki iki travma merkezi acil servisine ve beyin cerrahisi kliniğine 21 Mart-3 haziran 2020
ve 21 Mart-3 haziran 2019 tarihleri arası başvuran 65 yaş ve üzeri hastalar çalışmaya dahil edildi. Hastalar yaş cinsiyet travma tipi ve tedavi şekli olarak
retrospektif olarak değerlendirildi.
Bulgular: Çalışmamızda 21 Mart–3 Haziran 2019 tarihleri arasında 95 hasta hastaneye başvururken 21 Mart–3 Haziran 2020 tarihleri arasında 12 hasta
hastaneye başvurmuştu (p<0.001). 2019 yılının aynı döneminde hastaneye başvuran toplam 83 hastanın 4’ü erkek 40’ı ise kadın hasta iken 2020 yılında başvuran
12 hastanın 4’ü erkek iken 8’i kadın hastaydı (p=0.232). 2019 yılında başvuran hastaların 37’si izole kranial travma, 27’si izole spinal travma ve 19’u
ise spinal+ortopedik travma iken; 2020 yılında başvuran 12 hastanın 3‘ü izole kranial travma, 6’sı izole spinal travma ve 3’ü ise spinal+ortopedik travma
şeklindeydi (p=0.33). 2019 yılında ve kısıtlamaların olduğu dönemlerdeki geriatrik yaralanmaların en önemli sebebi düşmeydi.
Sonuç: Çalışmamızda gördüğümüz üzere travma en çok ev dışında meydana gelmektedir. Bu sebeple bu yaş grubu popülasyonunun ev dışı travmaya maruziyetinin
sebepleri araştırılmalı ve ona göre önlemler alınarak travmayı azaltacak çalışmalar yapılmalıdır.

Kaynakça

  • Schemitsch E, Bhandari M. Femoral neck fractures: Controversies and evidence. J Orthop Trauma. 2009;23(6):385.
  • Brooks SE, Peetz AB. Evidence-based care of geriatric trauma patients. Surg Clin North Am. 2017;97(5):1157–1174.
  • Callaway DW, Wolfe R. Geriatric trauma. Emerg Med Clin North Am. 2007;25(3):837–860.
  • Leslie MP, Baumgaertner MR. Osteoporotic pelvic ring ınjuries. Orthop Clin North Am. 2013;44(2):217–224.
  • Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: The challenges ahead. Lancet. 2009;374(9696):1196–1208.
  • Sadigh S, Reimers A, Andersson R, Laflamme L. Falls and fall-related ınjuries among the elderly: A Survey of residential-care facilities in a Swedish municipality. J Community Health. 2004;29(2):129–140.
  • Lowe JA, Pearson J, Leslie M, Griffin R. Ten-Year ıncidence of high-energy geriatric trauma at a level 1 Trauma Center. J Orthop Trauma. 2018;32(3):129–133.
  • Ramanathan DM, McWilliams N, Schatz P, Hillary FG. Epidemiological shifts in elderly traumatic brain ınjury: 18-year trends in Pennsylvania. J Neurotrauma . 2012;29(7):1371–1378.
  • McIntyre A, Mehta S, Aubut J, Dijkers M, Teasell RW. Mortality among older adults after a traumatic brain injury: A meta-analysis. Brain Inj. 2013;27(1):31–40.
  • Coronado VG, Thomas KE, Sattin RW, Johnson RL. The CDC Traumatic brain ınjury surveillance system. J Head Trauma Rehabil. 2005;20(3):215–228.
  • Chams N, Chams S, Badran R, Shams A, Araji A, Raad M et al. COVID-19: A multidisciplinary review. Front public Heal. 2020;8:383.
  • Paules CI, Marston HD, Fauci AS. Coronavirus Infections—more than just the common cold. JAMA. 2020;323(8):707–708.
  • Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 2020;46(3):505–510.
  • European Centre for Disease Prevention and Control. Guidance for health system contingency planning during widespread transmission of SARS-CoV-2 with high impact on healthcare services. Stock ECDC [Internet]. 2020; Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-guidance-health-systems-contingency-planning.pdf
  • Horst MA, Morgan ME, Vernon TM, Bradburn EH, Cook AD, Shtayyeh T et al. The geriatric trauma patient: A neglected individual in a mature trauma system. J Trauma Acute Care Surg. 2020;89(1):192–198.
  • Fidan S, Kurtoglu Celık G, Özhasenekler A, Şener A, Tanrıverdi F, Pamukçu Günaydın G ve ark. Evaluation of revised trauma score in geriatric trauma patients. Ankara Med J. 2020;20(3):578–587.
  • Aktürk A, Avcı A, Gülen M, Ay MO, İçme F, Satar S. Prospective Analysis of geriatric patients admitted to emergency department with trauma. Cukurova Med J [Internet]. 2013;38(4):687–695.
  • Bergeron E, Clement J, Lavoie A, Ratte S, Bamvita J-M, Aumont F et al. A simple fall in the elderly: Not so simple. J Trauma Inj Infect Crit Care. 2006;60(2):268–273.
  • Yildiz M, Bozdemir MN, Kiliçaslan I, Ateşçelik M, Gürbüz S, Mutlu B et al. Elderly trauma: The two years experience of a university-affiliated emergency department. Eur Rev Med Pharmacol Sci. 2012;16(Suppl 1):62–67.
  • Aktaş C, Eren SH, Eryilmaz M. Effects of co-morbid disease and drug consumption on trauma patients 65 years of age and older: A university emergency department experience. Ulus Travma Acil Cerrahi Derg. 2008;14(4):313–317.
  • Işık AT, Cankurtaran M, Doruk H, Mas MR. Geriatrik olgularda düşmelerin değerlendirilmesi. Turkish J Geriatr. 2006;9(1):45–50.
  • Guse CE, Porinsky R. Risk factors associated with hospitalization for unintentional falls: Wisconsin hospital discharge data for patients aged 65 and over. WMJ. 2003;102(4):37–42.
  • Adam SH, Eid HO, Barss P, Lunsjo K, Grivna M, Torab FC et al. Epidemiology of geriatric trauma in United Arab Emirates. Arch Gerontol Geriatr. 47(3):377–832.
  • Grossman MD, Miller D, Scaff DW, Arcona S. When Is an elder old? Effect of preexisting conditions on mortality in geriatric trauma. J Trauma Acute Care Surg. 2002;52(2):242–246.
  • Akköse Aydin S, Bulut M, Fedakar R, Ozgürer A, Ozdemir F. Trauma in the elderly patients in Bursa. Ulus Travma Acil Cerrahi Derg. 2006;12(3):230–234.
  • Gowing R, Jain MK. Injury patterns and outcomes associated with elderly trauma victims in Kingston, Ontario. Can J Surg. 2007;50(6):437–444.
  • Liberman M, Mulder DS, Sampalis JS. Increasing volume of patients at level I trauma centres: is there a need for triage modification in elderly patients with injuries of low severity? Can J Surg. 2003;46(6):446–452.

The Impact of Coronavirus-19 Lockdowns on The Number of Cranial and Spinal Trauma Cases in Geriatric Patients

Yıl 2023, Cilt: 18 Sayı: 2, 93 - 98, 12.07.2023
https://doi.org/10.17517/ksutfd.1208380

Öz

Objective: Geriatric patients are more prone to traumatic injuries, particularly cranial traumas and spinal fractures resulting from falls, due to osteoporosis
and sedentary lifestyles. As a primary measure against the Coronavirus-19 (Covid-19) pandemic, Turkey put into effect a lockdown for people aged 65 and
above. This study aimed to compare the change in the number of cranial and spinal trauma cases in the age group of 65 and above who were placed under
lockdown between 21st March and 3rd June 2020 with the number in the previous year.
Materials and Methods: The study included patients aged 65 and above who presented to the emergency departments and neurosurgery clinics of two
trauma centers in our city with cranial and spinal traumas between 21st March and 3rd June in 2019 and 2020. The patients were retrospectively categorized
in terms of age, gender, type of trauma and treatment.
Results: In total, 83 patients presented to the hospital between 21st March and 3rd June 2019 while only 12 patients presented between 21st March and 3rd
June 2020 (p<0.001). Of the 83 patients hospitalised in 2019, 43 were male and 40 were female, and of the 12 patients admitted in 2020, 4 were male and
8 were female (p=0.232). In 2019, 37 of the patients presented with isolated cranial trauma, 27 with isolated spinal trauma and 19 with spinal+orthopaedic
trauma. In 2020, 3 patients presented with isolated cranial trauma, 6 with isolated spinal trauma and 3 with spinal+orthopaedic trauma (p=0.33). Falls were
the most common cause of geriatric injuries in 2019 and during the lockdown period.
Conclusion: Our study reported that trauma was most likely to occur outside the home. Therefore, further research should be conducted to identify the
causes of trauma outside the home for this age group and measures need to be taken accordingly to the reduce occurrence of such traumas.s.

Kaynakça

  • Schemitsch E, Bhandari M. Femoral neck fractures: Controversies and evidence. J Orthop Trauma. 2009;23(6):385.
  • Brooks SE, Peetz AB. Evidence-based care of geriatric trauma patients. Surg Clin North Am. 2017;97(5):1157–1174.
  • Callaway DW, Wolfe R. Geriatric trauma. Emerg Med Clin North Am. 2007;25(3):837–860.
  • Leslie MP, Baumgaertner MR. Osteoporotic pelvic ring ınjuries. Orthop Clin North Am. 2013;44(2):217–224.
  • Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: The challenges ahead. Lancet. 2009;374(9696):1196–1208.
  • Sadigh S, Reimers A, Andersson R, Laflamme L. Falls and fall-related ınjuries among the elderly: A Survey of residential-care facilities in a Swedish municipality. J Community Health. 2004;29(2):129–140.
  • Lowe JA, Pearson J, Leslie M, Griffin R. Ten-Year ıncidence of high-energy geriatric trauma at a level 1 Trauma Center. J Orthop Trauma. 2018;32(3):129–133.
  • Ramanathan DM, McWilliams N, Schatz P, Hillary FG. Epidemiological shifts in elderly traumatic brain ınjury: 18-year trends in Pennsylvania. J Neurotrauma . 2012;29(7):1371–1378.
  • McIntyre A, Mehta S, Aubut J, Dijkers M, Teasell RW. Mortality among older adults after a traumatic brain injury: A meta-analysis. Brain Inj. 2013;27(1):31–40.
  • Coronado VG, Thomas KE, Sattin RW, Johnson RL. The CDC Traumatic brain ınjury surveillance system. J Head Trauma Rehabil. 2005;20(3):215–228.
  • Chams N, Chams S, Badran R, Shams A, Araji A, Raad M et al. COVID-19: A multidisciplinary review. Front public Heal. 2020;8:383.
  • Paules CI, Marston HD, Fauci AS. Coronavirus Infections—more than just the common cold. JAMA. 2020;323(8):707–708.
  • Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 2020;46(3):505–510.
  • European Centre for Disease Prevention and Control. Guidance for health system contingency planning during widespread transmission of SARS-CoV-2 with high impact on healthcare services. Stock ECDC [Internet]. 2020; Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-guidance-health-systems-contingency-planning.pdf
  • Horst MA, Morgan ME, Vernon TM, Bradburn EH, Cook AD, Shtayyeh T et al. The geriatric trauma patient: A neglected individual in a mature trauma system. J Trauma Acute Care Surg. 2020;89(1):192–198.
  • Fidan S, Kurtoglu Celık G, Özhasenekler A, Şener A, Tanrıverdi F, Pamukçu Günaydın G ve ark. Evaluation of revised trauma score in geriatric trauma patients. Ankara Med J. 2020;20(3):578–587.
  • Aktürk A, Avcı A, Gülen M, Ay MO, İçme F, Satar S. Prospective Analysis of geriatric patients admitted to emergency department with trauma. Cukurova Med J [Internet]. 2013;38(4):687–695.
  • Bergeron E, Clement J, Lavoie A, Ratte S, Bamvita J-M, Aumont F et al. A simple fall in the elderly: Not so simple. J Trauma Inj Infect Crit Care. 2006;60(2):268–273.
  • Yildiz M, Bozdemir MN, Kiliçaslan I, Ateşçelik M, Gürbüz S, Mutlu B et al. Elderly trauma: The two years experience of a university-affiliated emergency department. Eur Rev Med Pharmacol Sci. 2012;16(Suppl 1):62–67.
  • Aktaş C, Eren SH, Eryilmaz M. Effects of co-morbid disease and drug consumption on trauma patients 65 years of age and older: A university emergency department experience. Ulus Travma Acil Cerrahi Derg. 2008;14(4):313–317.
  • Işık AT, Cankurtaran M, Doruk H, Mas MR. Geriatrik olgularda düşmelerin değerlendirilmesi. Turkish J Geriatr. 2006;9(1):45–50.
  • Guse CE, Porinsky R. Risk factors associated with hospitalization for unintentional falls: Wisconsin hospital discharge data for patients aged 65 and over. WMJ. 2003;102(4):37–42.
  • Adam SH, Eid HO, Barss P, Lunsjo K, Grivna M, Torab FC et al. Epidemiology of geriatric trauma in United Arab Emirates. Arch Gerontol Geriatr. 47(3):377–832.
  • Grossman MD, Miller D, Scaff DW, Arcona S. When Is an elder old? Effect of preexisting conditions on mortality in geriatric trauma. J Trauma Acute Care Surg. 2002;52(2):242–246.
  • Akköse Aydin S, Bulut M, Fedakar R, Ozgürer A, Ozdemir F. Trauma in the elderly patients in Bursa. Ulus Travma Acil Cerrahi Derg. 2006;12(3):230–234.
  • Gowing R, Jain MK. Injury patterns and outcomes associated with elderly trauma victims in Kingston, Ontario. Can J Surg. 2007;50(6):437–444.
  • Liberman M, Mulder DS, Sampalis JS. Increasing volume of patients at level I trauma centres: is there a need for triage modification in elderly patients with injuries of low severity? Can J Surg. 2003;46(6):446–452.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Emrullah Cem Kesilmez 0000-0003-3905-2206

Zafer Yüksel 0000-0002-9234-5908

Erken Görünüm Tarihi 10 Temmuz 2023
Yayımlanma Tarihi 12 Temmuz 2023
Gönderilme Tarihi 22 Kasım 2022
Kabul Tarihi 19 Aralık 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 18 Sayı: 2

Kaynak Göster

AMA Kesilmez EC, Yüksel Z. The Impact of Coronavirus-19 Lockdowns on The Number of Cranial and Spinal Trauma Cases in Geriatric Patients. KSÜ Tıp Fak Der. Temmuz 2023;18(2):93-98. doi:10.17517/ksutfd.1208380