ATEŞLİ SİLAH YARALANMALI HASTALARDA MORTALİTEYİ ETKİLEYEN FAKTÖRLER

Year 2009, Volume: 22 Issue: 3, 181 - 191, 19.06.2015

Savaş Eriş Murat Orak Behçet Al , Cahfer Güloğlu Mustafa Aldemir

Abstract

ÖZET Amaç: Bu çalışmada birden fazla organda silah yaralanmasına maruz kalan hastalarda mortalitede etkili faktörleri tespit etmeyi amaçladık. Yöntem: Dicle Üniversitesi Tıp Fakültesi Acil Tıp Kliniğine Ocak 2000 ile Aralık 2004 arasında ASY nedeniyle başvuran 714 hastanın kayıtları geriye dönük olarak incelendi. Sağ kalanlar ve ölenler arasında mortalite üzerine etkisi olabileceğini düşündüğümüz; ileri yaş, cinsiyet, öz kıyım amaçlı olması, uzun namlulu silahla yaralanma, saçma atan silahlarla yaralanma, yakın atış, gecikmiş başvuru zamanı, başvuruda derin anemi ve şok varlığı, ateşli silah giriş sayısı ≥4 olması, yaralanma bölgeleri, ciddi kafa, toraks ve batın yaralanmasının olması, ekstremite vasküler yaralanması, multiple kan transfüzyonu yapılması, GKS, RTS ve PATİ değerleri analiz edildi. Bulgular: Ünivariete istatistiksel analizler neticesinde; öz kıyım amaçlı yaralanma (p=0.001), başvuruda derin anemi (p=0.001) ve şok varlığı (p=0.001), ciddi kafa yaralanması (p=0.001), ciddi toraks yaralanması (p=0.001) ve ciddi batın yaralanmasının olması (p=0.001), femoral arter yaralanması (p=0.001), multiple kan transfüzyonu (p=0.009), GKS’nın 0–7 ve 8–12 olması (p=0.001) ve düşük RTS skoru (p=0.001)’nun mortalite üzerinde anlamlı etkisinin olduğunu tespit ettik. Sonuç: Multivarite analiz sonucunda; başvuruda derin anemi varlığı, ciddi kafa travması varlığı, ciddi batın travması olması ve düşük RTS skoru mortaliteyi etkileyen en önemli bağımsız değişkenler olarak bulundu (p<0.05).

Anahtar Kelimeler: Faktörler, Silah atışı, Mortalite, Yaralanma, Ciddi anemi, Öz kıyım

Keywords

Faktörler, Silah atışı, Mortalite, Yaralanma, Ciddi anemi, Öz kıyım

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