Retrospective Evaluation Of Patients Who Were Treated In The Intensive Care Unit Due To Road Traffic Accidents

Yıl 2023, Cilt: 7 Sayı: 3, 219 - 225, 31.12.2023

Yıldız Yiğit , Nuriye Esen Bulut , Arzu Yıldırım Ar

https://doi.org/10.30565/medalanya.1293559

Öz

Aim:We aimed to investigate intensive care unit (ICU) treatments and factors associated with mortality in patients admitted to the ICU after road traffic accidents(RTAs).

Methods:This study retrospectively analyzed patient comorbidities,features of traumas,alcohol use,Revised Trauma Score(RTS), interventions performed,ICU and hospital stays,the presence and extent of invasive mechanical ventilation(IMV),Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Scores (SAPS II), as well as Glasgow Coma Scale (GCS) and NRS 2002 (Nutritional Risk Screening 2002) scores upon admission to the ICU. Brain death rates, transfusion rates, and ICU death rates were analyzed.

Results: 90 of the 109 patients treated in the ICU for RTAs survived, and 19 patients (17.4%) died.GCS scores were lower and APACHE II scores were greater in the non-surviving patients than in the surviving patients (p < 0.0001). The number of patients who received cardiopulmonary resuscitation (CPR) was significantly higher in the non-surviving patient group(p < 0.0001).The most frequent etiology of trauma was non-vehicle traffic accidents(45%).The head was the most common site of traumas(71.5%).The GCS and RTS scores of non-survivor patients were significantly lower(p = 0.013,p = 0.001,respectively), and the APACHE II and SAPS II scores were higher(p < 0.001).It was found that the rates of intubation(100%),CPR(47.4%), and IMV(100%) in non-surviving patients outweighed in surviving patients( p= 0.005,p < 0.001, and p = 0.012,respectively).

Conclusion:Multiple parameters are influential for determining the prognoses of patients treated in the ICU for traumas caused by RTAs.In particular,a high APACHE II score and CPR requirement are associated with mortality.

Anahtar Kelimeler

Road traffic accidents, intensive care unit, mortality

Karayolu Trafik Kazaları Nedeniyle Yoğun Bakım Ünitesinde Takip Ve Tedavi Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

Öz

Amaç: Karayolu trafik yaralanması sonrası yoğun bakım ünitesine(YBÜ) kabul edilen hastalarda ybü süreçleri ve mortalite ile ilişkili faktörleri incelemeyi amaçladık.

Yöntemler: Bu çalışmada retrospektif olarak hastaların komorbiditeleri, travmaların özellikleri, alkol kullanımı, Revize Travma Skoru (RTS), yapılan girişimler, yoğun bakım ve hastanede kalış süreleri, invaziv mekanik ventilasyonun (IMV) varlığı ve süresi, yoğun bakım ünitesine kabul sırasında;Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi ( APACHE II), Basitleştirilmiş Akut Fizyoloji Skorları (SAPS II) ve ayrıca Glasgow Koma Ölçeği (GCS) ve NRS 2002 (Beslenme Risk Taraması 2002) puanları incelendi. Beyin ölümü oranları, transfüzyon oranları ve yoğun bakım ünitesindeki ölüm oranları analiz edildi.

Bulgular: YBÜ'de RTA nedeniyle tedavi edilen 109 hastanın 90'ı hayatta kaldı ve 19 hasta (%17,4) öldü. Ölen hasta grubunda, sağ kalan hasta grubuna göre GKS skoru daha düşük ve APACHE II skorları yüksekdi (p<0.0001). Resusitasyon( KPR) uygulanan hasta sayısı, ölen hasta grubunda anlamlı şekilde yüksekdi (p<0.0001).En sık travma etyolojisi araç dışı trafik kazası idi (%45) . En sık %71,5 ile kafa travması görüldü.Ölen hastaların GKS ve RTS skorları , anlamlı düzeyde düşük olup (p:0.013) (p:0.001), APACHE II ve SAPS II skorları yüksek idi (p<0.001).Ölen hastaların entübe edilme (%100),KPR uygulanma (%47,4) ve IMV yapılma oranını (%100), sağ kalan hastalardan anlamlı düzeyde yüksek bulduk (p:0.005)(p<0,001) (p:0.012).

Sonuç: Karayolu trafik kazasına bağlı travma nedeniyle yoğun bakımda takip ve tedavi edilen hastaların prognoz tayininde farklı parametrelerin etkili olduğunu ve özellikle yüksek APACHE II ve KPR uygulanmasının mortalite ile ilişkili olduğu kanaatindeyiz.

Anahtar Kelimeler

Karayolu trafik kazaları, yoğun bakım ünitesi, mortalite

Kaynakça

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