Kafa travmalı olgularda prognozu belirleyen etkenler
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Dosyalar
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada, yetişkin kafa yaralanmalı olgularda hasta kayıt sistemimizden elde edilebilen verilerin sonuç üzerine etkisi araştırıldı. Trakya Üniversitesi Hastanesi Beyin ve Sinir Cerrahisi Anabilm Dalı ve Yoğun Bakım Ünitelerine yatırılan 356 Kafa yaralanmalı tanılı yetişkin olgunun kayıtları incelendi. Elde edilen veriler istatistiksel olarak incelendi. Bazı verilerin (cinsiyet, yaralanma nedenleri, eşlik eden yüz, spinal ve uzuv yaralanmaları, sağ-sol uzuv hareket farklılığı, kafatası kırıkları) sonuç üzerinde (ölüm oranı) anlamlı farklılık oluşturmadığı saptandı. Yaş (p=0,012), entübasyon (p<0,001), olay yeri ve Acil Birimde saptanan Glasgow Koma Ölçeği değerleri (p<0,001), kümelen sistolik ve diastolik tansiyon değerleri (p<0,001, eşlik eden göğüs (p=0,001) ve karın (p=0,041) yaralanması, anizokori (p=0,001), ışık refleksi (p<0,001), kafatası içi radyolojik bulgulardan subdural kanama (p<0,001), beyin ezilmesi (p=0,006), subaraknoid kanama (p<0,001), beyin içi kanama (p=0,005) ve BÖ (p<0,001), cerrahi girişim yapılması (p<0,001) ve hastane infeksiyonu varlığı (p<0,001) verilerinin sonuç üzerinde anlamlı farklılık oluşturduğu saptandı. Sonuç olarak, elde edilen bulgular başka vücut bölgelerinde yaralanma bulgularını olan veya olmayan yetişkin kafa yaralanmalı olgularda sonuç tahmininde kullanılabilir. Ayrıca KY olgularda ölüm oranının azaltılmasının en önemli basamağın kaza oluşumun azaltılması olduğu bilinmeli ve bu amaç için toplumsal eğitimin önemini vurgulanmalıdır. Anahtar kelimeler: Kafa yaralanması, Yaranlanma nedeni, Yaş, Glaskow Koma Ölçeği
Abstract
In this study, the data that can be obtained from our patient record system is investigated to effect on the outcome in the adult head injured patients. The records of 356 adult head injured patients hospitalized in Trakya University Hospital, Department of Neurosurgery and Intensive Care Unit have been examined. Result of the obtained data has been analyzed by statistically. Some of the data (sex, injury cause, accompanied by facial, spinal and limb injuries, the left-right differences in limb movement, skull fracture) do not make a significant difference on the outcome (death rate) has been detected. Age (p = 0.012), using airway tube (p <0.001), values of Glasgow Coma Scale was detected on injury side and Emergency Unit (p <0.001), clustered systolic and diastolic blood pressure values (p <0.001), accompanied by chest (p = 0.001) and abdominal (p = 0.041), injury, anisocoria (p = 0.001), pupillary ligth responce (p <0.001), intracranial radiologic findings such as; Subdural hematoma (p <0.001), brain contusion (p = 0.006), traumatic subarachnoid hemorrhage (p <0.001), traumatic Intracerebral hemorrhage (p = 0.005) and brain edema (p <0.001), doing surgical procedure (p <0.001) and presence of nosocomial infection (p <0.001) make significant differences on the outcome were found. As a result, the obtained findings can be used to predict the outcome in head injured adult case with or without other body regions of injury. In addition, to reducing the death rate in head injured cases the most important steps to reduce the occurring of the accident with the knowledge and for this purpose it should be stressed the importance of public education. Key words: Head trauma, Cause of injury, Age, Glasgow Come Scale.
Abstract
In this study, the data that can be obtained from our patient record system is investigated to effect on the outcome in the adult head injured patients. The records of 356 adult head injured patients hospitalized in Trakya University Hospital, Department of Neurosurgery and Intensive Care Unit have been examined. Result of the obtained data has been analyzed by statistically. Some of the data (sex, injury cause, accompanied by facial, spinal and limb injuries, the left-right differences in limb movement, skull fracture) do not make a significant difference on the outcome (death rate) has been detected. Age (p = 0.012), using airway tube (p <0.001), values of Glasgow Coma Scale was detected on injury side and Emergency Unit (p <0.001), clustered systolic and diastolic blood pressure values (p <0.001), accompanied by chest (p = 0.001) and abdominal (p = 0.041), injury, anisocoria (p = 0.001), pupillary ligth responce (p <0.001), intracranial radiologic findings such as; Subdural hematoma (p <0.001), brain contusion (p = 0.006), traumatic subarachnoid hemorrhage (p <0.001), traumatic Intracerebral hemorrhage (p = 0.005) and brain edema (p <0.001), doing surgical procedure (p <0.001) and presence of nosocomial infection (p <0.001) make significant differences on the outcome were found. As a result, the obtained findings can be used to predict the outcome in head injured adult case with or without other body regions of injury. In addition, to reducing the death rate in head injured cases the most important steps to reduce the occurring of the accident with the knowledge and for this purpose it should be stressed the importance of public education. Key words: Head trauma, Cause of injury, Age, Glasgow Come Scale.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Nöroşirürji, Neurosurgery, Kafa Yaralanması, Glasgow Come Scale, Yaş, Glaskow Koma Ölçeği, Head Trauma, Cause of Injury,, Age
