Acil Servise Motosiklet, Bisiklet ve Scooter Kazaları Nedeni İle Başvuran ve Ekstremite Kırıkları Olan Hastaların Analizi

Öz

Bu çalışmanın amacı 2018-2022 yılları arasında motosiklet, bisiklet ve scooter kazaları sonrası acil servise başvuran ve ekstremite yaralanması saptanan hastaların klinik özelliklerinin değerlendirilmesidir.01.10.2018 - 31.10.2022 tarihleri arasında bir üniversite hastanesi acil servisine motosiklet, bisiklet ve scooter kazası nedeniyle başvuran olguların kayıtları retrospektif olarak incelenmiştir. Acil servise başvuran 1204 motosiklet, 573 bisiklet ve 123 scooter olmak üzere toplam 1900 trafik kazası olgusu çalışmaya alındı. Olguların %87,7’si erkekti ve yaş ortalaması 27,9±11,4 yıldı. Kazaların en sık (%40,7) yaz aylarında ve mesai sonrası saatler olan 17:00–00:00 arasında (%40,8) meydana geldiği görüldü. Olguların %13,5’inde üst ekstremite, %10,6’sında alt ekstremite fraktürü saptandı. Üst ekstremitede en sık fraktür saptanan kemikler sırasıyla; radius (%4,2), humerus (%2,1) ve klavikula (%2,1) iken, en sık alt ekstremite fraktürü saptanan kemikler tibia (%4,1), fibula (%2,7) ve metatarsal kemikler (%1,9) idi. Olguların %81,4’ü taburcu olurken, %3,2’si yoğun bakım ünitesi (YBÜ)’ne yatırıldı ve %0,4’ü ise eksitus oldu. Çok değişkenli lojistik regresyon analizi sonuçlarına göre; herhangi bir alt ekstremite kemiğinde fraktür varlığı (OR: 2,250 [%95 GA: 1,211 - 4,180], p= 0,012) ve konsültasyon istenmesi (OR: 2,004 [%95 GA: 1,180 - 3,404], p= 0,011) diğer değişkenlerden bağımsız olarak yoğun bakım ünitesine yatış/eksitus ile ilişki saptandı. Alt ekstremite kemiklerinde fraktür saptanan ve herhangi bir nedenle konsültasyon istenen olgular arasında yoğun bakım ünitesine yatış/ eksitus riski daha yüksekti. Bu risk faktörlerine sahip olgularda, daha hızlı planlama ve uygun müdahalenin erken dönemde yapılması ile morbidite ve mortalite oranları azaltmada yardımcı olabilir.

Anahtar Kelimeler

• acil servis
• motosiklet kazası
• scooter kazası

Etik Beyan

Bu çalışma için Bursa Uludağ Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu’ndan izin alındı (Karar no: 2022-18/10)

Analysis of Patients with Extremity Fractures Admitted to the Emergency Department Due to Motorcycle, Bicycle and Scooter Accidents

Öz

The aim of this study is to evaluate the clinical characteristics of patients who applied to the emergency department after motorcycle, bicycle and scooter accidents between 2018 and 2022 and were found to have extremity injuries. The records of the cases who applied to the emergency department of an university hospital due to motorcycle, bicycle and scooter accidents between 01.10.2018 and 31.10.2022 were examined retrospectively. A total of 1900 traffic accident cases, including 1204 motorcycles, 573 bicycles and 123 scooters, who were admitted to the emergency department, were included in the study. 87.7% of the cases were male and the average age was 27.9±11.4 years. It was observed that accidents occurred most frequently (40.7%) in the summer months and between 17:00 and 00:00 (40.8%), which are after working hours. Upper extremity fractures were detected in 13.5% of the cases and lower extremity fractures in 10.6%. The most common bones with fractures in the upper extremity are; radius (4.2%), humerus (2.1%) and clavicle (2.1%), while the most common bones with lower extremity fractures are tibia (4.1%), fibula (2.7%) and metatarsal bones. (1.9%). While 81.4% of the cases were discharged, 3.2% were admitted to the intensive care unit and 0.4% died. According to the results of multivariate logistic regression analysis; Presence of fracture in any lower extremity bone (OR: 2.250 [95% CI: 1.211 - 4.180], p= 0.012) and request for consultation (OR: 2.004 [95% CI: 1.180 - 3.404], p= 0.011) independently of other variables A relationship was detected with ICU admission/exit. The risk of admission to the intensive care unit/exit was higher among cases in which fractures were detected in the lower extremity bones and consultation was requested for any reason. In cases with these risk factors, faster planning and early appropriate intervention may help reduce morbidity and mortality rates.

Anahtar Kelimeler

• emergency department
• motorcycle accident
• scooter accident.

Kaynakça

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