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Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.417891

Health Care Administration

Sağlık Kurumları Yönetimi

Postoperative mortality following civilian firearms injury during war: A retrospective cohort study

Savaş sırasında sivil ateşli silah yaralanmalarını takiben ortaya çıkan mortalite: Retrospektif bir kohort araştırması

Okşar

Menekşe

Mustafa Kemal University Hospital Akkurt

Cagla

Mustafa Kemal University Hospital Turhanoglu

Selim

Mustafa Kemal University Hospital

06 01 2019

26 2 131 140 04 23 2018 04 25 2018

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Background: This study aims to identifyfactors affecting mortality following surgery for civilian firearms injuries using surgical classification as a surrogatemarker of injury severity.Methods: This was a retrospective study of patients who underwent surgery at atertiary university hospital in Turkey between 2011 and 2014. All patients hadsustained firearms injury and had an American Society of Anesthesiologistsscore of I-II. A grading systemdefined by the Communiqué on Health Practices in Turkeywas used based on the surgerytype and anesthetic procedure to determine the severity of injury and itsrelation with patient outcome (survival or death).Results: The median duration of hospital stay of patients who were discharged posthealing was significantly longer than those who died [12 (0–559).vs 7.5 (0–468)days, respectively]. Overall mortalitywas 11.3%; however, the mortality of patients was 8.1%,40.3%, and 40.3% in groups A2, C, and D, respectively. Healing in groups A2, C,and D was 2.4%, 54.1% and 25.8%, respectively. Independent variables affecting the coefficientof patient discharge status for sex, age, andsurgical groups A2, C, and D were found to be significant.Conclusion:Therewas an association between the surgical groups and thefirearms injuries sustained by civilians. Moreover, the coefficients associated withsurgical group in our model may help predict the mortality risk in similarpopulations.

Amaç: Bu çalışma savaş yaralanması nedeni ile ameliyat edilen hastalararasında, cerrahi grupların sınıflandırmasını yaralanma şiddetinin yerinekullanarak, mortaliteyi etkileyen faktörleri tanımlamayı amaçlamaktadır.Yöntem: Bu Türkiye’de bir üçüncü basamak üniversite hastanesinde 2011 ve2014 yılları arasında ameliyata alınan hastalarda yapılan retrospektif birçalışmadır. Tüm hastalar ateşli silah yaralanması nedeni ile ameliyata alınmışve ASA skorları I–II idi. Yaralanmanın şiddetini ve hastanın son durumunu (sağkalım veya ölüm) saptamak için cerrahinin tipi ve bununla ilişkili anesteziişlemine dayalı bir derecelendirme sistemi-Türkiye’de Sağlık UygulamalarıTebliğinde tanımlandığı şekli ile- kullanıldı.İstatistiksel analiz sonuçları: Şifa ile taburcuolanların hastane süreleri ölenlerden anlamlı dercede daha uzundu [medyan(min-maks.) olarak sırası ile 12 (0-559).ve 7.5(0-468) gün]. Hastalar altı kategorik cerrahi gruba (A2, A3, B,C, D, ve E) dağılmıştı. Tüm mortalite %11.3 idi ancak A2, C, ve D gruplarındahastaların sırası ile %8.1, %40.3 ve %40.3’ü, ve şifa-sağ kalım yine A2, C, Dgrup hastalarda sırası ile %2.4, %54.1, %25.8 oranında idi. Hastanın sondurumunu etkileyen bağımsız değişkenlerin cinsiyet, yaş ve cerrahi gruplardanA2, C ve D için katsayıları anlamlı idi.Sonuç: Cerrahioperasyon kategorileri ve sivil ateşli silah yaralanmaları arasında bir ilişkiolduğu gözükmektedir, Dahası, modelimizdeki cerrahi grupları ile ilişkilikatsayılar benzer populasyonlarda mortalite riskini tahmin etmeye yardımcıolabilir.

firearms injury postoperative mortality war njury

ateşli silah yaralanması postoperatif mortalite savaş yaralanması

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