Acil Servise Sternal Fraktür Tanısıyla Başvuran Hastaların Klinik Sonuçlarının Değerlendirilmesi: Retrospektif Bir Çalışma

Öz

Amaç: Bu çalışmada, sternal fraktür tanısıyla acil servise başvuran hastaların klinik özellikleri, eşlik eden yaralanmaları, tedavi yöntemleri ve kısa dönem sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu retrospektif ve kesitsel çalışma, 1 Ocak 2019 ile 31 Aralık 2024 tarihleri arasında bilgisayarlı tomografi ile sternal fraktür tanısı almış 18 yaş ve üzeri hastaları kapsamaktadır. Demografik veriler, travma mekanizmaları, yaralanma türleri, laboratuvar bulguları, tedavi süreçleri ve klinik sonuçlar analiz edildi. Bulgular: Toplam 114 hastanın %68,4’ü erkekti ve ortalama yaş 53,6±17,9 idi. En sık travma nedeni künt travmaydı (%99,1). Fraktürler en çok sternum korpusunda (%55,3) ve manubriumda (%48,2) görüldü. Eşlik eden en yaygın torasik yaralanmalar kaburga fraktürü (%58,8) ve pulmoner kontüzyon (%35,1) idi. İzole sternal fraktür oranı %28,1’di. Acil servis mortalite oranı %1,8 (2/114) olarak saptanırken, acil servis ölümleri de dâhil olmak üzere toplam 30 günlük mortalite oranı %10,5 (12/114) idi. Mortalitenin, pulmoner kontüzyonu veya multipl yaralanması bulunan hastalarda anlamlı olarak daha yüksek olduğu belirlendi. Göğüs travma skoru ≥5 olan hastalarda mortalite anlamlı düzeyde artmıştı (p=0,029). Hastaların çoğu konservatif olarak tedavi edilmiş, sadece %1,8’ine cerrahi uygulanmıştır. Sonuç: Sternal fraktürler, özellikle eşlik eden torasik komplikasyonlarla birlikte olduğunda önemli morbidite ve mortaliteye neden olabilir. Yüksek riskli hastaların erken belirlenmesinde travma skorları ve klinik bulguların kullanılması tedavi yönetimini optimize edebilir.

Anahtar Kelimeler

• Sternum
• kemik kırıkları
• torasik yaralanmalar
• akciğer hasarı
• acil tıp

CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY

Öz

Objective: This study aimed to evaluate the clinical features, associated injuries, treatment approaches, and short-term outcomes of patients presenting to the emergency department with sternal fractures. Material and Methods: This retrospective cross-sectional study included patients aged 18 years and older who were diagnosed with a sternal fracture via computed tomography between January 1, 2019, and December 31, 2024. Demographics, trauma mechanisms, injury types, lab findings, treatment strategies, and outcomes were analyzed. Results: A total of 114 patients were included; 68.4% were male with a mean age of 53.6±17.9 years. The most common trauma mechanism was blunt trauma (99.1%). Fractures were mostly located in the sternal body (55.3%) and manubrium (48.2%). Rib fractures (58.8%) and pulmonary contusions (35.1%) were the most frequent concomitant injuries. Isolated sternal fractures occurred in 28.1% of patients. Emergency-department mortality was 1.8% (2/114), and overall 30-day mortality was 10.5% (12/114), including ED deaths, significantly higher among those with pulmonary contusions or multiple injuries. A chest trauma score of ≥5 was also significantly associated with increased mortality (p=0.029). Most patients were managed conservatively, with only 1.8% undergoing surgery. Conclusion: Sternal fractures may result in considerable morbidity and mortality, especially when accompanied by thoracic complications. Utilizing trauma scores and clinical findings can assist in identifying high-risk patients and guide treatment decisions.

Anahtar Kelimeler

• Sternum
• bone fractures
• thoracic injuries
• lung injuries
• emergency medicine

Kaynakça

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