Analysis of Tree-related Falls in Terms of Thoracolumbar Injury Classification System Scores and Patient Outcomes

Abstract

Aim: Falling from trees are main problems of occupational healthcare. Patients falling from trees are suffered from spinal and extremity injuries due to high energy traumas. Our aim with this study was to reveal the differences in thoracolumbar injury classification system (TLICS) scores, degrees of spinal damage and treatments of traumas belonging to patients who presented with falls from different tree species in different plantations. Material and Methods: This is a retrospective observational study. Patients who were brought to the emergency department due to falling from a tree between 2015-2020 were included. Characteristics of injuries due to falls from trees, TLICS scores, treatment types and 3 month follow up results were obtained from the hospital information system and comparative analysis was done. Results: The mean age of the patients was 53.25±17.9 years and 54.9% were male. 33(64.7%) patients had undergone vertebroplasty or stabilization. According to height categories, TLICS scores(p=0.003) and stabilization levels(p=0.003) were statistically higher in taller tree categories (p=0.003). Although surgical interventions were statistically higher in tree falls higher than four meters (p=0.026), there was no statistically significant difference between trees in terms of treatment type (p=0.315), VAS score (p=0.219) and 30-day VAS score (p=. 0.329) In addition, the change in Visual Analogue Scale (VAS) score was statistically higher in operated patients (median VAS=7) than in non-operated patients (median VAS=5.5) (p=0.012). Conclusion: Our findings reveal that TLICS scores are significantly associated with tree heights and operate with good results in VAS scores.

Keywords

• spinal injury
• trauma
• tree falls

Ağaçtan Düşmelerin Torakolomber Yaralanma Sınıflandırma Sistemi Skorları ve Hasta Sonuçları Açısından Analizi

Abstract

Amaç: Ağaçtan düşmeler, iş sağlığı hizmetlerinin temel sorunlarından biridir. Ağaçtan düşen hastalar, yüksek enerjili travmalar nedeniyle omurga ve ekstremite yaralanmalarına maruz kalmaktadır. Bu çalışma ile amacımız, farklı plantasyonlardaki farklı ağaç türlerinden düşme ile gelen hastalara ait torakolomber yaralanma sınıflandırma sistemi (TLICS) skorları, spinal hasar dereceleri ve travma tedavilerindeki farklılıkları ortaya koymaktır. Gereç ve Yöntemler: Bu retrospektif gözlemsel bir çalışmadır. 2015-2020 yılları arasında ağaçtan düşme nedeniyle acil servise getirilen hastalar dahil edildi. Ağaçtan düşmelere bağlı yaralanmaların özellikleri, TLICS skorları, tedavi türleri ve 3 aylık takip sonuçları hastane bilgi sisteminden alınarak karşılaştırmalı analizler yapılmıştır. Bulgular: Hastaların ortalama yaşı 53,25±17,9 olup, %54,9’u erkekti. Düşmelerin en çok zeytin ağacından olduğu görüldü(n=23, %45,1) Hastaların 33'üne (%64,7) vertebroplasti veya stabilizasyon uygulandı. Boy kategorilerine göre TLICS puanları(p=0.003) ve stabilizasyon düzeyleri(p=0.003) istatistiksel olarak yüksek ağaç kategorilerinde daha yüksek bulundu (p=0.003). Dört metreden yüksek ağaç düşmelerinde cerrahi müdahaleler istatistiksel olarak daha yüksek olmakla birlikte (p=0,026), tedavi şekli (p=0,315), VAS skoru(p=0,219) ve 30 gün VAS skoru açısından ağaçlar arasında istatistiksel olarak anlamlı fark yoktu(p=0.329)Ayrıca Görsel Analog Ölçeği (VAS) skorundaki değişim opere olan hastalarda (median VAS=7) opere olmayan hastalara göre (median VAS=5,5) istatistiksel olarak daha yüksekti (p=0,012). Sonuç: Bulgularımız, TLICS puanlarının ağaç boyları ile anlamlı bir şekilde ilişkili olduğunu ve VAS puanlarında iyi sonuçlarla çalıştığını ortaya koymaktadır.

Keywords

• ağaçtan düşme
• spinal yaralanma
• travma

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