Akademik Veri Yönetim Sistemi
Tezin Türü: Yüksek Lisans
Tezin Yürütüldüğü Kurum: Bezmiâlem Vakıf Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Türkiye
Tezin Onay Tarihi: 2022
Tezin Dili: Türkçe
Öğrenci: Saadet Akbalık
Danışman: Bahadır Taşlıdere
Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
Özet:
ANALYSIS OF PATIENTS ATTENDING TO THE EMERGENCY DEPARTMENT WITH
FIRE-GUN INJURIES
SUMMARY
Purpose and Hypothesis: To investigate
the conditions that have an impact on the mortality of patients admitted to the
emergency department due to high kinetic energy gunshot wounds. For this
purpose; The aim of this study is to compare the demographic structure of the
patients, injury site, surgical indications, laboratory values and trauma
scores, and to discuss their differences with studies conducted in our country
and around the world, and their reasons.
Method: Our study was carried out
between 01 January 2016 and 31 December 2016. The patients were divided into
two groups as living and deceased. Age, gender, occurrence of the event, vital
signs, injury site, involving more than one anatomical area, surgical treatment
requirement, whether fracture surgery was performed, chest tube insertion
status, laboratory parameters were compared. ISS, RTS and TRISS scores were
compared between groups with living and deceased patients. Cut of values were
calculated by performing ROC analysis. How useful they are in estimating
mortality was investigated. The research data were recorded in IBM SPSS
Statistics for Windows, version 21.0 and statistical analysis was performed.
Finding: 127 patients over the age of
18 who applied to the emergency department due to high kinetic energy gun
injury and were brought directly from the area were included. The patients were
divided into two groups as living and deceased. When the laboratory findings of
the patients were examined; Considering the trauma scores, it was seen that the
ISS averages of the living individuals were lower than the deceased
individuals, and the average of the RTS and TRISS scores of the surviving
individuals was higher than the deceased individuals. The mean Systolic Blood
Pressure of the living individuals is lower compared to the deceased
individuals, the Respiratory Number of the deceased individuals is higher than
the living individuals, and the GCS averages of the deceased individuals are
significantly lower than the living individuals.
Conclusion: In patients brought to the emergency
room with individual gunshot wounds, vital signs and laboratory tests should be
evaluated quickly and trauma scores with proven effectiveness such as ISS, RTS
and TRISS should be calculated. These trauma scores differed between deceased
and surviving patients. It should be known that mortality is high in gunshot
wounds with head, neck and spinal injuries. In addition, patients with vascular
injuries should be given priority. In cases of firearm injury, it is the most
accurate method to make a decision with evidence-based findings obtained by
utilizing the way the event occurred, the site of injury, vital signs,
laboratory values and trauma scores.
Keywords: Firearm, Trauma Score,
Mortality