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Çocuk Yoğun Bakım Takibi Gerektiren Pediatrik Travma Hastalarının Değerlendirilmesi ve Mülteci Çocuklara ait Farklılıkların Belirlenmesi

Yıl 2021, Cilt 15, Sayı 5, 394 - 399, 23.09.2021
https://doi.org/10.12956/tchd.955627

Öz

Amaç: Bu çalışmanın amacı, pediatrik yoğun bakım takibi gereken travma hastalarında, travma nedenlerini ve klinik seyrini incelemek ve mülteci çocuklar özelinde demografik özellikler, travma oluşum mekanizması, travma şiddeti ve prognoz açısından olası farklılıkları değerlendirmektir.

Gereç ve Yöntemler: 1 Mayıs 2020-30 Nisan 2021 tarihleri arasında çocuk yoğun bakım ünitemize travma ön tanısı ile başvuran 175 hastanın kayıtları geriye dönük olarak incelendi. Hastalar Türk vatandaşları ve Suriye vatandaşları (mülteci hastalar) olarak iki gruba ayrıldı. Elde edilen veriler bu iki grup arasında karşılaştırıldı.

Bulgular: Hastaların 119’u (%68) T.C. vatandaşı ve 56’sı (%32) mülteci hastaydı. T.C. vatandaşı hastaların ortanca yaşı 6 (3-12; IQR) ve mülteci hastaların ortanca yaşı 4 (2-10; IQR) olarak saptandı (p=0.092). T.C. vatandaşlarının 70’i (%58.8), mülteci hastaların 43’ü (%76.8) erkekti (p=0.027). Araç içi trafik kazası T.C. vatandaşların 27’sinde (%22.7), mülteci hastaların 4’ünde (%7.2) görüldü ve farklılık istatistiksel olarak anlamlı bulundu (p=0.011). Mülteci hastalardaki araç dışı trafik kazası oranı T.C. vatandaşlarına göre daha fazlaydı (%23.2 ve %10; sırasıyla) (p=0.035). Travma nedeni ile 10 hasta hayatını kaybetmişti. Ölen hastaların yedisi (%5.8) T.C. vatandaşı, üçü (%5.3) göçmendi.

Sonuç: Çalışmamızda mülteci çocuklarda araç dışı trafik kazasının daha fazla görüldüğünü ancak her iki grupta klinik olarak bir fark olmadığını saptadık. Göçmen sorunlarının daha dikkatli değerlendirilmesi, çocuk nüfusuna odaklı projeler ve çalışmalar, sosyo-ekonomik koşullarının iyileştirilmesi, eğitim sistemine düzenli katılımın sağlanması yaralanma oranlarını azaltabileceğini düşünmekteyiz.

Kaynakça

  • Coulthard MG, Varghese V, Harvey LP, Gillen TC, Kimble RM, Ware RS. A review of children with severe trauma admitted to pediatric intensive care in Queensland, Australia. PLoS One 2019;14:e0211530.
  • Doocy S, Lyles E, Akhu-Zaheya L, Burton A, Weiss W. Health service utilization and access to medicines among Syrian refugee children in Jordan. Int J Health Plann Manage 2016;31:97–112.
  • Guha-Sapir D, Panhuis WG. Conflict-related mortality: An analysis of 37 datasets. Disasters 2004;28:418–28.
  • Aydın D, Şahin N, Akay B. Göç Olayının Çocuk Sağlığı Üzerine Etkileri. Behcet Uz Cocuk Hast Derg 2017;7:8-14.
  • Korkmaz AÇ. Sığınmacıların Sağlık ve Hemşirelik Hizmetlerine Yarattığı Sorunlar. Sağlık ve Hemşirelik Yönetimi Dergisi 2014;1:37-42.
  • Friedl NK, Muensterer OJ. Special aspects in pediatric surgical inpatient care of refugee children: a comparative cohort study. Children (Basel) 2019; 6:62.
  • Pohl C, Mack I, Schmitz T, Ritz N. The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015. Eur J Pediatr 2017;176:1681–7.
  • Öztan MO, Bolova G, Sayan A, Özdemir T, Anıl AB, Elmalı F, et al. Çocuk cerrahisi servisinde Travma nedeniyle izlenen Suriyeli hastaların türk hastalarla karşılaştırılması, J Pediatr Emerg Intensive Care Med 2019;6:30-4.
  • Öztan MO, Anıl M, Anıl AB, Yaldız D, Uz İ, Turgut A, et al. First step toward a better trauma management: Initial results of the Northern Izmir Trauma Registry System for children. Ulus Travma Acil Cerrahi Derg 2019; 25:20-8.
  • Hon KL, Huang S, Poon WS, Cheung HM, Ip P, Zee B. Mortality And Morbidity of Severe Traumatic Brain Injuries; A Pediatric Intensive Care Unit Experience Over 15 Years. Bull Emerg Trauma 2019;7:256-62.
  • Zwingmann J, Schmal H, Mehlhorn A, Südkamp NP, Strohm PC. Injury patterns in polytraumatized children and consequences for the emergency room management. Acta Chir Orthop Traumatol Cech 2010;77:365–70.
  • Syria Regional Refugee Response. Inter-Agency Information Sharing Portal. [Last cited on 2021 Jun 02]. Available from: https://data2.unhcr.org/en/situations/syria/location/113.
  • Hutchings HA, Evans A, Barnes P, Demmler JC, Heaven M, Healy MA, et al. Residential Moving and Preventable Hospitalizations. Pediatrics 2016;138: e20152836.
  • Svantner J, Dolci M, Heim C, Schoettker P. Pediatric trauma: six years of experience in a Swiss trauma center. Pediatr Emerg Care 2019 Dec 13. doi: 10.1097/PEC.0000000000001925. Online ahead of print.
  • Syria’s Mental Health Crisis. Brookings Institute. 2016. Available online: https://www.brookings.edu/blog/future-development/2016/04/25/syrias-mental-health-crisis/ (accessed on 15 August 2019).
  • Ongun EA, Dursun O. Prediction of mortality in pediatric traumatic brain injury: Implementations from a tertiary pediatric intensive care facility Ulus Travma Acil Cerrahi Derg 2018;24:199-206.
  • Bayrak A, Öztürk V, Koluman A, Ziroğlu N, Duramaz A. Injury characteristics and management of orthopaedic trauma in refugee children. Int Orthop 2021;45:649-56.
  • Huang YT, Huang YH, Hsieh CH, Li CJ, Chiu IM. Comparison of Injury Severity Score, Glasgow Coma Scale, and Revised Trauma Score in Predicting the Mortality and Prolonged ICU Stay of Traumatic
  • Young Children: A Cross-Sectional Retrospective Study. Emerg Med Int 2019:5453624.
  • Tambay G, Satar S, Kozacı N, Açıkalın A. Retrospective analysis of pediatric trauma cases admitted to the emergency medicine department. JAEM 2013; 12:812.
  • Ellison P, Cifarelli D, Pearce A, Moore L, Parrish D, Ellison M, Fazi A, et al. Incidence, Prevalence, and Outcomes of Pediatric Trauma in Rural Appalachia (West Virginia) From 2017 to 2019. Cureus 2021;13:e14245.
  • Schoeneberg C, Schilling M, Keitel J, Burggraf M, Hussmann B, Lendemans S. Mortality in severely injured children: experiences of a German level 1 trauma center (2002–2011). BMC Pediatr 2014;14:194.
  • Nance ML, Kallan MJ, Arbogast KB. Factors associated with clinically significant head injury in children involved in motor vehicle crashes. Traffic Inj Prev 2010;11:600-5.
  • Ludvigsson JF, Stiris T, Del Torso S, Mercier JC, Valiulis A, Hadjipanayis A. European Academy of Paediatrics Statement: Vision zero for child deaths in traffic accidents. Eur J Pediatr 2017;176:291-2.
  • Tucker B, Aston J, Dines M, Caraman E, Yacyshyn M, McCarthy M, et al. Early Brain Edema is a Predictor of In-Hospital Mortality in Traumatic Brain Injury. J Emerg Med 2017;53:18-29.
  • Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev 2016;22:3–18.

Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children

Yıl 2021, Cilt 15, Sayı 5, 394 - 399, 23.09.2021
https://doi.org/10.12956/tchd.955627

Öz

Objective: This study aimed to examine the causes and clinical course of trauma in trauma patients requiring pediatric intensive care unit (PICU) follow-up and evaluate possible differences related to demographic characteristics, trauma mechanism, trauma severity, and prognosis in refugee children.

Material and Methods: The records of 175 patients admitted to our PICU between May 1, 2020 and April 30, 2021 with a preliminary diagnosis of trauma were retrospectively reviewed. The patients were divided into two groups as Turkish citizens and Syrian citizens (refugee children). The obtained data were compared between these two groups.

Results: 119 (68%) were Turkish citizens and 56 (32%) were refugees. The median age of the Turkish citizens was 6 (3–12; IQR) years and the median age of the refugee patients was 4 (2–10; IQR) years (p = 0.092). Further, 70 (58.8%) of the Turkish citizens and 43 (76.8%) of the refugee patients were males (p = 0.027). In-vehicle traffic accidents were observed in 27 (22.7%) of the Turkish citizens and 4 (7.2%) of the refugee patients, with the difference being statistically significant (p = 0.011). The rate of non-vehicle traffic accident in the refugee patients was higher than that in the Turkish citizens (23.2% and 10%, respectively) (p = 0.035). Ten patients died due to trauma, of which 7 (5.8%) patients were Turkish citizens and 3 (5.3%) were refugee patients.

Conclusion: In our study, we found that non-vehicle traffic accidents were more common in refugee patients, but there was no clinical difference between Turkish citizens and refugee patients. We think that more careful evaluation of immigrant problems, projects, and studies focused on the child population, improvement of socioeconomic conditions, and regular participation in the education system can reduce injury rates.

Kaynakça

  • Coulthard MG, Varghese V, Harvey LP, Gillen TC, Kimble RM, Ware RS. A review of children with severe trauma admitted to pediatric intensive care in Queensland, Australia. PLoS One 2019;14:e0211530.
  • Doocy S, Lyles E, Akhu-Zaheya L, Burton A, Weiss W. Health service utilization and access to medicines among Syrian refugee children in Jordan. Int J Health Plann Manage 2016;31:97–112.
  • Guha-Sapir D, Panhuis WG. Conflict-related mortality: An analysis of 37 datasets. Disasters 2004;28:418–28.
  • Aydın D, Şahin N, Akay B. Göç Olayının Çocuk Sağlığı Üzerine Etkileri. Behcet Uz Cocuk Hast Derg 2017;7:8-14.
  • Korkmaz AÇ. Sığınmacıların Sağlık ve Hemşirelik Hizmetlerine Yarattığı Sorunlar. Sağlık ve Hemşirelik Yönetimi Dergisi 2014;1:37-42.
  • Friedl NK, Muensterer OJ. Special aspects in pediatric surgical inpatient care of refugee children: a comparative cohort study. Children (Basel) 2019; 6:62.
  • Pohl C, Mack I, Schmitz T, Ritz N. The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015. Eur J Pediatr 2017;176:1681–7.
  • Öztan MO, Bolova G, Sayan A, Özdemir T, Anıl AB, Elmalı F, et al. Çocuk cerrahisi servisinde Travma nedeniyle izlenen Suriyeli hastaların türk hastalarla karşılaştırılması, J Pediatr Emerg Intensive Care Med 2019;6:30-4.
  • Öztan MO, Anıl M, Anıl AB, Yaldız D, Uz İ, Turgut A, et al. First step toward a better trauma management: Initial results of the Northern Izmir Trauma Registry System for children. Ulus Travma Acil Cerrahi Derg 2019; 25:20-8.
  • Hon KL, Huang S, Poon WS, Cheung HM, Ip P, Zee B. Mortality And Morbidity of Severe Traumatic Brain Injuries; A Pediatric Intensive Care Unit Experience Over 15 Years. Bull Emerg Trauma 2019;7:256-62.
  • Zwingmann J, Schmal H, Mehlhorn A, Südkamp NP, Strohm PC. Injury patterns in polytraumatized children and consequences for the emergency room management. Acta Chir Orthop Traumatol Cech 2010;77:365–70.
  • Syria Regional Refugee Response. Inter-Agency Information Sharing Portal. [Last cited on 2021 Jun 02]. Available from: https://data2.unhcr.org/en/situations/syria/location/113.
  • Hutchings HA, Evans A, Barnes P, Demmler JC, Heaven M, Healy MA, et al. Residential Moving and Preventable Hospitalizations. Pediatrics 2016;138: e20152836.
  • Svantner J, Dolci M, Heim C, Schoettker P. Pediatric trauma: six years of experience in a Swiss trauma center. Pediatr Emerg Care 2019 Dec 13. doi: 10.1097/PEC.0000000000001925. Online ahead of print.
  • Syria’s Mental Health Crisis. Brookings Institute. 2016. Available online: https://www.brookings.edu/blog/future-development/2016/04/25/syrias-mental-health-crisis/ (accessed on 15 August 2019).
  • Ongun EA, Dursun O. Prediction of mortality in pediatric traumatic brain injury: Implementations from a tertiary pediatric intensive care facility Ulus Travma Acil Cerrahi Derg 2018;24:199-206.
  • Bayrak A, Öztürk V, Koluman A, Ziroğlu N, Duramaz A. Injury characteristics and management of orthopaedic trauma in refugee children. Int Orthop 2021;45:649-56.
  • Huang YT, Huang YH, Hsieh CH, Li CJ, Chiu IM. Comparison of Injury Severity Score, Glasgow Coma Scale, and Revised Trauma Score in Predicting the Mortality and Prolonged ICU Stay of Traumatic
  • Young Children: A Cross-Sectional Retrospective Study. Emerg Med Int 2019:5453624.
  • Tambay G, Satar S, Kozacı N, Açıkalın A. Retrospective analysis of pediatric trauma cases admitted to the emergency medicine department. JAEM 2013; 12:812.
  • Ellison P, Cifarelli D, Pearce A, Moore L, Parrish D, Ellison M, Fazi A, et al. Incidence, Prevalence, and Outcomes of Pediatric Trauma in Rural Appalachia (West Virginia) From 2017 to 2019. Cureus 2021;13:e14245.
  • Schoeneberg C, Schilling M, Keitel J, Burggraf M, Hussmann B, Lendemans S. Mortality in severely injured children: experiences of a German level 1 trauma center (2002–2011). BMC Pediatr 2014;14:194.
  • Nance ML, Kallan MJ, Arbogast KB. Factors associated with clinically significant head injury in children involved in motor vehicle crashes. Traffic Inj Prev 2010;11:600-5.
  • Ludvigsson JF, Stiris T, Del Torso S, Mercier JC, Valiulis A, Hadjipanayis A. European Academy of Paediatrics Statement: Vision zero for child deaths in traffic accidents. Eur J Pediatr 2017;176:291-2.
  • Tucker B, Aston J, Dines M, Caraman E, Yacyshyn M, McCarthy M, et al. Early Brain Edema is a Predictor of In-Hospital Mortality in Traumatic Brain Injury. J Emerg Med 2017;53:18-29.
  • Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev 2016;22:3–18.

Ayrıntılar

Birincil Dil İngilizce
Konular Genel ve Dahili Tıp
Bölüm ÖZGÜN ARAŞTIRMALAR
Yazarlar

Serhat EMEKSİZ> (Sorumlu Yazar)
ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ
0000-0002-8951-4774
Türkiye


Esra KOÇKUZU>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0002-5760-349X
Türkiye


Leman AKCAN YILDIZ>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0003-2584-6144
Türkiye


Ali Kansu TEHÇİ>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0002-9914-3321
Türkiye


Başak ALAN>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0003-2463-289X
Türkiye


Recep KAR>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK CERRAHİSİ ANABİLİM DALI
0000-0002-7099-8991
Türkiye


Medine Ezgi ÖCAL>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK CERRAHİSİ ANABİLİM DALI
0000-0002-3436-3497
Türkiye

Yayımlanma Tarihi 23 Eylül 2021
Başvuru Tarihi 2 Temmuz 2021
Kabul Tarihi 5 Ağustos 2021
Yayınlandığı Sayı Yıl 2021, Cilt 15, Sayı 5

Kaynak Göster

Bibtex @araştırma makalesi { tchd955627, journal = {Türkiye Çocuk Hastalıkları Dergisi}, issn = {1307-4490}, eissn = {2148-3566}, address = {Şehit Ömer Halisdemir Cad. Kurtdereli Sok. No:10 ANKARA}, publisher = {T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi}, year = {2021}, volume = {15}, number = {5}, pages = {394 - 399}, doi = {10.12956/tchd.955627}, title = {Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children}, key = {cite}, author = {Emeksiz, Serhat and Koçkuzu, Esra and Akcan Yıldız, Leman and Tehçi, Ali Kansu and Alan, Başak and Kar, Recep and Öcal, Medine Ezgi} }
APA Emeksiz, S. , Koçkuzu, E. , Akcan Yıldız, L. , Tehçi, A. K. , Alan, B. , Kar, R. & Öcal, M. E. (2021). Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children . Türkiye Çocuk Hastalıkları Dergisi , 15 (5) , 394-399 . DOI: 10.12956/tchd.955627
MLA Emeksiz, S. , Koçkuzu, E. , Akcan Yıldız, L. , Tehçi, A. K. , Alan, B. , Kar, R. , Öcal, M. E. "Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children" . Türkiye Çocuk Hastalıkları Dergisi 15 (2021 ): 394-399 <https://dergipark.org.tr/tr/pub/tchd/issue/64980/955627>
Chicago Emeksiz, S. , Koçkuzu, E. , Akcan Yıldız, L. , Tehçi, A. K. , Alan, B. , Kar, R. , Öcal, M. E. "Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children". Türkiye Çocuk Hastalıkları Dergisi 15 (2021 ): 394-399
RIS TY - JOUR T1 - Çocuk Yoğun Bakım Takibi Gerektiren Pediatrik Travma Hastalarının Değerlendirilmesi ve Mülteci Çocuklara ait Farklılıkların Belirlenmesi AU - SerhatEmeksiz, EsraKoçkuzu, LemanAkcan Yıldız, Ali KansuTehçi, BaşakAlan, RecepKar, Medine EzgiÖcal Y1 - 2021 PY - 2021 N1 - doi: 10.12956/tchd.955627 DO - 10.12956/tchd.955627 T2 - Türkiye Çocuk Hastalıkları Dergisi JF - Journal JO - JOR SP - 394 EP - 399 VL - 15 IS - 5 SN - 1307-4490-2148-3566 M3 - doi: 10.12956/tchd.955627 UR - https://doi.org/10.12956/tchd.955627 Y2 - 2021 ER -
EndNote %0 Türkiye Çocuk Hastalıkları Dergisi Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children %A Serhat Emeksiz , Esra Koçkuzu , Leman Akcan Yıldız , Ali Kansu Tehçi , Başak Alan , Recep Kar , Medine Ezgi Öcal %T Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children %D 2021 %J Türkiye Çocuk Hastalıkları Dergisi %P 1307-4490-2148-3566 %V 15 %N 5 %R doi: 10.12956/tchd.955627 %U 10.12956/tchd.955627
ISNAD Emeksiz, Serhat , Koçkuzu, Esra , Akcan Yıldız, Leman , Tehçi, Ali Kansu , Alan, Başak , Kar, Recep , Öcal, Medine Ezgi . "Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children". Türkiye Çocuk Hastalıkları Dergisi 15 / 5 (Eylül 2021): 394-399 . https://doi.org/10.12956/tchd.955627
AMA Emeksiz S. , Koçkuzu E. , Akcan Yıldız L. , Tehçi A. K. , Alan B. , Kar R. , Öcal M. E. Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children. Türkiye Çocuk Hast Derg. 2021; 15(5): 394-399.
Vancouver Emeksiz S. , Koçkuzu E. , Akcan Yıldız L. , Tehçi A. K. , Alan B. , Kar R. , Öcal M. E. Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children. Türkiye Çocuk Hastalıkları Dergisi. 2021; 15(5): 394-399.
IEEE S. Emeksiz , E. Koçkuzu , L. Akcan Yıldız , A. K. Tehçi , B. Alan , R. Kar ve M. E. Öcal , "Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children", Türkiye Çocuk Hastalıkları Dergisi, c. 15, sayı. 5, ss. 394-399, Eyl. 2021, doi:10.12956/tchd.955627

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