Blunt Abdominal Trauma Analysis in the Deaths due to Traffic Accidents in Erzurum, Turkey

Yıl 2021, Cilt: 2 Sayı: 1, 5 - 9, 25.01.2021

Mustafa Talip Şener Talip Vural Yiğit Sezer Ahmet Nezih Kök

Öz

Background: Traffic accidents are one of the most common causes of death in many countries. Death-causing lesions mostly occur in the head-neck, chest, and abdominal region, respectively.
Traffic accidents are an important cause of blunt abdominal trauma. Data on abdominal trauma in fatal traffic accidents are limited in autopsy series.
Objectives: In this study, we aimed to determine the frequency of abdominal trauma, the severity of trauma and its effects on the cause of death in traffic accident deaths.
Methods: A retrospective analysis of autopsy cases of the Morgue Department of the Council of Forensic Medicine, Erzurum Branch between January 2015 - June 2019 was conducted. The sample size was determined using the Epi-Info version 7 statistics program.
Results: The mean age of the cases was 41.1 years (sd:23.4; min:1 - max:96); 76.1% were male. Pre-hospital death occurred in 53.4%, while in the remaining 46.6%, death occurred during hospitalisation. 31.1% of the cases had abdominal trauma. Most commonly injured solid organ was liver in 57.3% of the abdominal trauma cases. Abdominal traumas and liver injuries were more common in pre-hospital deaths, especially in the accident scene deaths (p<.001). Besides, type A liver injury was more common in pre-hospital deaths (p=.002).
Conclusions: Liver trauma is one of the leading causes of pre-hospital deaths due to traffic accidents. Type A liver traumas were more lethal.

Anahtar Kelimeler

Traffic accident, Blunt abdominal trauma, Pre-hospital death, Liver injury

Kaynakça

• 1. Vyas D, Hollis M, Abraham R, Rustagi N, Chandra S, Malhotra A, et al. Prehospital care training in a rapidly developing economy: A multi-institutional study. J Surg Res. 2016;203(1):22-27.
• 2. Van der Vlies CH, Olthof DC, Gaakeer M, Ponsen KJ, van Delden OM, Goslings JC. Changing patterns in diagnostic strategies and the treatment of blunt injury to solid abdominal organs. Int J Emerg Med. 2011;4(1):47.
• 3. Raikwar R, Brahmane A, Arora S. Retrospective and prospective study of management and outcome of blunt abdomen trauma in tertiary health center in last 5-year 2009-2014. J Evol Med Dent Sci. 2015;4(43):7449-7457.
• 4. Sungur İ, Akdur R, Piyal B. Analysis of Traffic Accidents in Turkey. Ankara Med J. 2014;14(3):114-124.
• 5. Christmas AB, Wilson AK, Manning B, Franklin GA, Miller FB, Richardson JD, et al. Selective management of blunt hepatic injuries including nonoperative management is a safe and effective strategy. Surgery. 2005;138(4):606-611.
• 6. Asensio JA, Demetriades D, Chahwan S, Gomez H, Hanpeter D, Velmahos G, et al. Approach to the management of complex hepatic injuries. J Trauma Acute Care Surg. 2000;48(1):66.
• 7. Fahim NK, Negida A, Fahim AK. Sample Size Calculation Guide-Part 3: How to Calculate the Sample Size for an Independent Case-control Study. Adv J Emerg Med. 2019;3(2):e20-e.
• 8. Khoshmohabat H, Paydar S, Karami MY, Makarem A, Dastgheib SN, Pourdavood A, et al. SURGICEL compared with simple gauze packing in grade IV liver injury: an experimental study. Comp Clin Pathol. 2019;28(2):467-471.
• 9. Girgin S, Gedik E, Tacyildiz I. Evaluation of surgical methods in patients with blunt liver trauma. Turkish J Emerg Med. 2006;12(1):35-42.
• 10. Slotta J, Justinger C, Kollmar O, Kollmar C, Schäfer T, Schilling M. Liver injury following blunt abdominal trauma: a new mechanism-driven classification. Surg. Today. 2014;44(2):241-246.
• 11. Kim H-Y. Statistical notes for clinical researchers: assessing normal distribution (2) using skewness and kurtosis. Restor Dent Endod. 2013;38(1):52-54.
• 12. WHO. Global status report on road safety 2018, https://www.who.int/violence_injury_prevention/road_safety_status/2018/en/. [Accessed on 30 October 2019 ].
• 13. Lee W-C, Chen C-W, Lin Y-K, Lin T-Y, Kuo L-C, Cheng Y-C, et al. Association of head, thoracic and abdominal trauma with delayed diagnosis of co-existing injuries in critical trauma patients. Injury. 2014;45(9):1429-1434.
• 14. Wisner DH, Kuppermann N, Cooper A, Menaker J, Ehrlich P, Kooistra J, et al. Management of children with solid organ injuries after blunt torso trauma. J Trauma Acute Care Surg. 2015;79(2):206-214.
• 15. Reddy NB, Hanumantha PM, Reddy NN, Reddy CS. An epidemiological study on pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents of Bangalore: Autopsy-based study. J Emerg Trauma Shock. 2014;7(2):116.
• 16. Sosada K, Wiewióra M, Piecuch J. Literature review of non-operative management of patients with blunt splenic injury: impact of splenic artery embolization. Videosurg Other Miniinvasive Tech. 2014;9(3):309.
• 17. Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Prac. 2014;4(2).
• 18. Zwingmann J, Schmal H, Südkamp N, Strohm PC. Injury severity and localisations seen in polytraumatised children compared to adults and the relevance for emergency room management. Zentralbl Chir. 2008;133(1):68-75.
• 19. Anadol AZ, Topgül K, Güngör B, Bilgin M, Kesim M. Non-operative management of blunt hepatic trauma. Turkish J Emerg Med. 2007;13(3):222-226.
• 20. Matthes G, Stengel D, Seifert J, Rademacher G, Mutze S, Ekkernkamp A. Blunt liver injuries in polytrauma: results from a cohort study with the regular use of whole-body helical computed tomography. World J Surg. 2003;27(10):1124-1130.
• 21. Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology. 2012;265(3):678-693.
• 22. Gholipour C, Rad BS, Vahdati SS, Fahimi R, Amir G, Far LM. Assessment of Causes of Preventable Deaths in Pre-hospital Settings. Erciyes Med J. 2016;38(2):66-69.
• 23. Katayama Y, Kitamura T, Kiyohara K, Sado J, Hirose T, Matsuyama T, et al. Prehospital factors associated with death on hospital arrival after traffic crash in Japan: a national observational study. Bmj Open. 2019;9(1).
• 24. Pfeifer R, Teuben M, Andruszkow H, Barkatali BM, Pape HC. Mortality Patterns in Patients with Multiple Trauma: A Systematic Review of Autopsy Studies. PLoS One. 2016;11(2):e0148844.
• 25. Yasin MN, Shen Y. Is Road Safety Moving Forward in Europe between 2011–2015?. 19th COTA International Conference of Transportation Proffesionals. CICTP 2019. p. 3771-3783.
• 26. Ma CX, Hao W, Xiang W, Yan W. The Impact of Aggressive Driving Behavior on Driver-Injury Severity at Highway-Rail Grade Crossings Accidents. J Adv Transport. 2018. https://doi.org/10.1155/2018/9841498.
• 27. Baygeldi S, Karakose O, Özcelik KC, Pülat H, Damar S, Eken H, et al. Factors affecting morbidity in solid organ injuries. Dis Markers.2016. https://doi.org/10.1155/2016/6954758.