Acil servise başvuran iki yaş altındaki travma vakalarının analizi ve radyolojik görüntüleme oranlarının değerlendirilmesi

Mustafa Alpaslan

Klinik Araştırma

Acil servise başvuran iki yaş altındaki travma vakalarının analizi ve radyolojik görüntüleme oranlarının değerlendirilmesi

Yıl 2024, Cilt: 16 Sayı: 1, 15 - 20, 30.04.2024

Mustafa Alpaslan

Öz

ÖZET
Amaç: Bu çalışmada özellikle yeni hareketlenmeye başlayan iki yaş altındaki çocukluk çağı travmaları incelenerek en sık görülen travma çeşitleri ve acil serviste tanıya yönelik yapılan görüntüleme yöntemleri ile sonuçlarının analizi yapılmak istenmiştir.
Gereç ve Yöntem: İkinci basamak bir hastanede retrospektif olarak 01.01.2022-31.12.2022 tarihleri arasında acil servise travma sonrası başvuran iki yaş altındaki hastaların hastane elektronik verileri üzerinden taranması ile yapıldı. Yaşı 24 ay ve altında olan vakalar değerlendirmeye alındı. Travma sonucunda meydana gelen yaralanmalar ve sonuçlar analiz edildi.
Bulgular: Çalışma kapsamında 1310 hasta değerlendirildi. Ortalama yaş 15,09±5,71 ay olup hastaların %55,4’ü erkekti. En sık %76,6 oranla düşme sonrası başvuru olduğu görüldü. Travmadan en fazla etkilenen bölgeler sırasıyla kafa ve ekstremitelerdi. Hastaların %42,7’ sine röntgen ve %37’sine tomografi çekildi. Tomografilerin %99,5 i baş ve boyun bölgesine yönelik çekildi. Yirmi hasta hastaneye yatırılarak tedavi altına alınırken hastaların 15’i beyin cerrahi ve 5’i ortopedi kliniklerine yatırıldı. Çalışmada ölümle sonlanan vaka olmadı.
Sonuç: İki yaş altındaki çocuklarda en sık düşmeye bağlı travmalar görülmektedir. En sık etkilenen vücut bölgesi ise sırayla baş ve ekstremitelerdir. Bunların dışında yanık ve yabancı cisim yutma ve/veya aspirasyon vakaları da sık görülmektedir.
Anahtar kelimeler: Acil servis,çocuk,travma,düşme

Anahtar Kelimeler

Acil servis, düşme, çocuk travma

Kaynakça

1. Kidder K, Stein J, Fraser J. The Health of Canada’s Children. A CICH Profile 3rd ed. Ottawa, Canadian Institute of Child Health, 2000.
2. Committee on Injury and Poison Prevention. American Academy of Pediatrics: Falls from heights: windows, roofs and balconies. Pediatrics. 2001; 107: 1188-91.
3. Abbassinia M, Barati M, Afshari M. Effectiveness of interventions in the prevention of home injuries among children under 5 years of age: A systematic review. ArchTraumaRes. 2019; 8: 190-7.
4. Celep G, Yardımcı F. Safety measures adopted by mothers to avoid undesired injuries at home. Sürekli Tıp Eğitimi Dergisi. 2021; 30: 96-106.
5. Kılıç E, Bayazit T, Gündoğdu G, Koşaroğlu NE, Sümer H. The prevalence of home accident and the effective factors in Sivas provincial in nursry and kinder garten children. Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2019;1:14-25.
6. Fingerhut LA, Annest JL, Baker SP, Kochanek KD, McLoughlin E. Injury mortality among children and teenagers in the United States, 1993. InjPrev. 1996; 2: 93-4.
7. Demirci B, Coşkun A. "Evaluation of forensic fall from height cases aged two years and younger." Cukurova Medical Journal 2022; 47(4): 1558-67.
8. Akay MA, Gürbüz N, Yayla D, Elemen EL, Yıldız GE, Esen HK ve ark. Acil servise başvuran pediatrik travma olgularının değerlendirilmesi. Kocaeli Tıp Dergisi. 2013; 2(3): 1-5.
9. Doğan Z, Güven FMK, Cankorkmaz L, Korkmaz İ, Coşkun A, Doles KA. Evaluation of the child trauma cases applied to our university hospital department of emergency. Turkish Archives Of Pediatrics. 2011; 46(2): 164-67.
10. Fidancı İ, Derinöz O, Tokgöz A. Cases admitted to pediatric emergency department due to trauma related to fall. Pediatric Practice and Research. 2021; 9: 5-10.
11. Rajagopal M, Kundra M, Mabood N, Ali S, Rankin T, Dow N, et al. Pediatric injuries due to falls from windows and balconies: an 8 year prospective and retrospective review. Pediatr Child Health. 2021; 26(5): 222-28.
12. Günal Y. Evaluation of pediatric patients admitted to a tertiary care hospital with blunt trauma with in one year. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2020; 22: 216-24.
13. Kilic S, Taskinlar H, Bahadir G, Isbir C, Nayci A. Analysis of pediatric trauma patients falling down from height. Mersin Universitesi Saglık Bilimleri Dergisi. 2016; 3: 131-7.
14. Pipas L, Schaefer N, Brown LH. Falls from roof tops after heavy snow falls: the risks of snow clearing activities. Am J EmergMed. 2002; 20: 635-7.
15. Koppolu R. Pediatric falls from windows: A health policy model for prevention. J Pediatr Health Care.2014; 28: 182-5.
16. Pomerantz WJ, Gittelman MA, Hornung R, Husseinzadeh H. Falls in children birth to 5 years: different mechanisms lead to different injuries. J Trauma Acute Care Surg. 2012; 73: 254-7
17. Özdemir AA, Elgormus Y, Cag Y. Evaluation of The Pediatric Forensic Cases Admitted to Emergency Department . Int J Basic Clin Med. 2016; 4: 1-8.
18. Cooper A, Barlow B, Discala C,String D. Mortality and truncal injury: The pediatric perspective. J Pediatr Surg 1994; 29: 33-8.
19. Kart Y, Bilaloğlu E, Duman L, Büyükyavuz Bİ, Savaş MÇ. Assessment of patients followed up in pediatric surgery service due to trauma: a retrospective 5-year study. Med J SDU. 2021; 28: 537-41.
20. Cetinkaya EA, Arslan İB, Cukurova İ. Nasal foreign bodies in children: Types, locations, complications and removal. Int J Pediatr Otorhinolaryngol 2015; 79: 1881-5.
21. Bakhshaee M, Hebrani P, Shams M, Salehi M, Ghaffari A, Rajati M. Psychological status in children with ear and nose foreign body insertion. Int J Pediatr Otorhinolaryngol 2017; 92: 103-7.
22. Abou Elfadl M, Horra A, Abada RL, Mahtar M, Roubal M, Kadiri F. Nasalforeign bodies: Results of a study of 260 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132: 343-6.
23. Arana A, Hauser B, Hachimi Idrissi S, Vandenplas Y. Management of ingested foreign bodies in childhood and review of the literature. Eur J Pediatr 2001; 160: 468-72.
24. Tiryaki T, Doğancı T, Livanelioğlu Z, Atayurt H. Çocukluk çağında yabancı cisim yutulması. Turkiye Klinikleri Pediatr 2004; 13: 67-70.
25. Yalçin S, Karnak I, Ciftci AO, Senocak ME, Tanyel FC, Büyükpamukçu N. Foreign body ingestion in children: an analysis of pediatric surgical practise. Pediatr Surg Int 2007; 23: 755-761
26. Şayık D, Açıkgöz A, Musmul A, Ulukuş A. Yanık ile Acile Başvuran 0-18 Yaş Grubu Olguların Özelliklerinin Geriye Dönük Belirlenmesi. DÜ Sağlık Bil Enst Derg. 2016; 6(1): 14-18.
27- Akansel N, Yılmaz S, Aydın N, Kahveci R. Etiology of Burn Injuries Among 0-6 Aged Children in One University Hospital Burn Unit, Bursa, Turkey. International Journal of Caring Sciences 2013; 6(2): 208-215.
28- Güzel A, Soyoral L, Öncü MR, Çakır C. Yanık Ünitemize Başvuran ve Cerrahi Müdahale Yapılan Olguların İncelenmesi. Van Tıp Dergisi 2012; 19 (1): 1-7.
29- Çiftçi İ, Arslan K, Altunbaş Z, Kara F, Yılmaz H. Epidemiologic Evaluation of Patients with Major Burns and Recommendations for Burn Prevention. Turkish Journal of Trauma&EmergencySurgery 2012; 18(2): 105-10.
30- Yılmaz S, Sezer E, Karagöz N, Erçöçen AR, Sezer H, Erkan M ve ark. Sivas’ta Alan Taramasıyla Yanık İnsidansının Araştırılması. Türkiye Klinikleri Journal of MedSciences 2010; 30(5): 1552-60.
31. Kamboj A, Chounthirath T, Xiang H, Smith GA. Traumatic brain injuries associated with consumer products at home among US children younger than 5 years of age. Clin Pediatr (Phila). 2017; 56: 545-54.
32. Bendçi B, Uysal G. Retrospective Evaluation of Pediatric Patients monitored with Trauma in Emergency Service: Three-Years Evaluation ArchHealthSciRes 2020; 7(2): 123-8.
33. Schneier AJ, Shields BJ, Hostetler SG, Xiang H, Smith GA. Incidence of pediatric traumatic brain injury and associated hospital resourceutilization in the United States. Pediatrics. 2006; 118(2): 483-92.
34. Chua KS, Ng YS, Yap SG, Bok CW. A Brief Review of Traumatic Brain Injury Rehabilitation. AnnAcadMedSingapore. 2007; 36(1): 31-42.
35. Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012; 380(4): 499-505.
36. Rajaraman P, Simpson J, Neta G, Berrington de Gonzalez A, Ansell P, Linet MS et al. Early life exposure to diagnostic radiation and ultrasound scans and risk of childhood cancer: case control study. BMJ. 2011; 10: 342.
37. Spady DW, Saunders DL, Schopflocher DP, Svensson LW. Patterns of injury in children. Pediatrics 2004; 113(3): 522-9.
38. Zümrüt M. Acil Servise Başvuran Çocuklarda Kırıkların Epidemiyolojik Değerlendirmesi. Kocatepe tıp dergisi. 2014; 15(2): 142-46.
39. Schalamon J, Dampf S, Singer G,Georg MD, Petnehazy AH, Thomas H, et al. Evaluation offractures in children and adolescents in a level 1 trauma center in Austria. J Trauma 2011; 71(2): 19-25.
40. Halsey MF. Pediatric pulled elbow injury: more common and recurrent than you think. Acta Pediatr 2019; 107(11): 1850.
41. Ohbuchi H, Hagiwara S, Hirota K, Koseki H, Kuroi Y, Arai N, et al. Clinical predictors of intracranial injuries in infants with minor head trauma. World Neurosurg. 2017; 98: 479-83.
42. Şahin S, Doğan Ş, Aksoy K. Çocukluk çağı kafa travmaları. Uludağ Tıp Derg. 2002; 28(2): 45-51.
43. Mtaweh H, Bell MJ. Management of pediatric traumatic brain injury. Curr Treat Options Neurol. 2015; 17: 348.

Analysis and evaluation of radiological ımaging rates of trauma cases under the age of two presenting to the emergency department

Yıl 2024, Cilt: 16 Sayı: 1, 15 - 20, 30.04.2024

Mustafa Alpaslan

Öz

ABSTRACT
Aim: In this study, it was aimed to analyze the most common trauma types and the imaging methods performed for diagnosis in the emergency department, by examining the childhood traumas under the age of two, which have just begun to mobilize.
Materials and Methods: This study was conducted retrospectively by scanning the hospital electronic data of patients under the age of two who applied to the emergency department after trauma between 01.01.2022 and 31.12.2022 in a secondary care hospital. Cases aged 24 months and below were evaluated. Injuries resulting from trauma and consequences were analyzed.
Results: 1310 patients were evaluated within the scope of the study. The mean age was 15.09±5.71 month years and 55.4% of the patients were male. It was seen that the most frequent application was after falling with a rate of 76.6%. The areas most affected by trauma were the head and extremities, respectively. Direct graphy and tomography were performed in 42.7% of the patients. 99.5% of the tomographies were taken towards the head and neck region. While 20 patients were hospitalized and treated, 15 of them were hospitalized in neurosurgery and 5 in orthopedics clinics. There was no case that ended in death in the study.
Conclusion: Fall related trauma is the most common trauma in children under the age of two. The most commonly affected body parts are the head and extremities, respectively. Apart from these, burns and foreign body ingestion and/or aspiration cases are also common.

Anahtar Kelimeler

Emergency department, fall, child trauma

Kaynakça

1. Kidder K, Stein J, Fraser J. The Health of Canada’s Children. A CICH Profile 3rd ed. Ottawa, Canadian Institute of Child Health, 2000.
2. Committee on Injury and Poison Prevention. American Academy of Pediatrics: Falls from heights: windows, roofs and balconies. Pediatrics. 2001; 107: 1188-91.
3. Abbassinia M, Barati M, Afshari M. Effectiveness of interventions in the prevention of home injuries among children under 5 years of age: A systematic review. ArchTraumaRes. 2019; 8: 190-7.
4. Celep G, Yardımcı F. Safety measures adopted by mothers to avoid undesired injuries at home. Sürekli Tıp Eğitimi Dergisi. 2021; 30: 96-106.
5. Kılıç E, Bayazit T, Gündoğdu G, Koşaroğlu NE, Sümer H. The prevalence of home accident and the effective factors in Sivas provincial in nursry and kinder garten children. Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2019;1:14-25.
6. Fingerhut LA, Annest JL, Baker SP, Kochanek KD, McLoughlin E. Injury mortality among children and teenagers in the United States, 1993. InjPrev. 1996; 2: 93-4.
7. Demirci B, Coşkun A. "Evaluation of forensic fall from height cases aged two years and younger." Cukurova Medical Journal 2022; 47(4): 1558-67.
8. Akay MA, Gürbüz N, Yayla D, Elemen EL, Yıldız GE, Esen HK ve ark. Acil servise başvuran pediatrik travma olgularının değerlendirilmesi. Kocaeli Tıp Dergisi. 2013; 2(3): 1-5.
9. Doğan Z, Güven FMK, Cankorkmaz L, Korkmaz İ, Coşkun A, Doles KA. Evaluation of the child trauma cases applied to our university hospital department of emergency. Turkish Archives Of Pediatrics. 2011; 46(2): 164-67.
10. Fidancı İ, Derinöz O, Tokgöz A. Cases admitted to pediatric emergency department due to trauma related to fall. Pediatric Practice and Research. 2021; 9: 5-10.
11. Rajagopal M, Kundra M, Mabood N, Ali S, Rankin T, Dow N, et al. Pediatric injuries due to falls from windows and balconies: an 8 year prospective and retrospective review. Pediatr Child Health. 2021; 26(5): 222-28.
12. Günal Y. Evaluation of pediatric patients admitted to a tertiary care hospital with blunt trauma with in one year. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2020; 22: 216-24.
13. Kilic S, Taskinlar H, Bahadir G, Isbir C, Nayci A. Analysis of pediatric trauma patients falling down from height. Mersin Universitesi Saglık Bilimleri Dergisi. 2016; 3: 131-7.
14. Pipas L, Schaefer N, Brown LH. Falls from roof tops after heavy snow falls: the risks of snow clearing activities. Am J EmergMed. 2002; 20: 635-7.
15. Koppolu R. Pediatric falls from windows: A health policy model for prevention. J Pediatr Health Care.2014; 28: 182-5.
16. Pomerantz WJ, Gittelman MA, Hornung R, Husseinzadeh H. Falls in children birth to 5 years: different mechanisms lead to different injuries. J Trauma Acute Care Surg. 2012; 73: 254-7
17. Özdemir AA, Elgormus Y, Cag Y. Evaluation of The Pediatric Forensic Cases Admitted to Emergency Department . Int J Basic Clin Med. 2016; 4: 1-8.
18. Cooper A, Barlow B, Discala C,String D. Mortality and truncal injury: The pediatric perspective. J Pediatr Surg 1994; 29: 33-8.
19. Kart Y, Bilaloğlu E, Duman L, Büyükyavuz Bİ, Savaş MÇ. Assessment of patients followed up in pediatric surgery service due to trauma: a retrospective 5-year study. Med J SDU. 2021; 28: 537-41.
20. Cetinkaya EA, Arslan İB, Cukurova İ. Nasal foreign bodies in children: Types, locations, complications and removal. Int J Pediatr Otorhinolaryngol 2015; 79: 1881-5.
21. Bakhshaee M, Hebrani P, Shams M, Salehi M, Ghaffari A, Rajati M. Psychological status in children with ear and nose foreign body insertion. Int J Pediatr Otorhinolaryngol 2017; 92: 103-7.
22. Abou Elfadl M, Horra A, Abada RL, Mahtar M, Roubal M, Kadiri F. Nasalforeign bodies: Results of a study of 260 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132: 343-6.
23. Arana A, Hauser B, Hachimi Idrissi S, Vandenplas Y. Management of ingested foreign bodies in childhood and review of the literature. Eur J Pediatr 2001; 160: 468-72.
24. Tiryaki T, Doğancı T, Livanelioğlu Z, Atayurt H. Çocukluk çağında yabancı cisim yutulması. Turkiye Klinikleri Pediatr 2004; 13: 67-70.
25. Yalçin S, Karnak I, Ciftci AO, Senocak ME, Tanyel FC, Büyükpamukçu N. Foreign body ingestion in children: an analysis of pediatric surgical practise. Pediatr Surg Int 2007; 23: 755-761
26. Şayık D, Açıkgöz A, Musmul A, Ulukuş A. Yanık ile Acile Başvuran 0-18 Yaş Grubu Olguların Özelliklerinin Geriye Dönük Belirlenmesi. DÜ Sağlık Bil Enst Derg. 2016; 6(1): 14-18.
27- Akansel N, Yılmaz S, Aydın N, Kahveci R. Etiology of Burn Injuries Among 0-6 Aged Children in One University Hospital Burn Unit, Bursa, Turkey. International Journal of Caring Sciences 2013; 6(2): 208-215.
28- Güzel A, Soyoral L, Öncü MR, Çakır C. Yanık Ünitemize Başvuran ve Cerrahi Müdahale Yapılan Olguların İncelenmesi. Van Tıp Dergisi 2012; 19 (1): 1-7.
29- Çiftçi İ, Arslan K, Altunbaş Z, Kara F, Yılmaz H. Epidemiologic Evaluation of Patients with Major Burns and Recommendations for Burn Prevention. Turkish Journal of Trauma&EmergencySurgery 2012; 18(2): 105-10.
30- Yılmaz S, Sezer E, Karagöz N, Erçöçen AR, Sezer H, Erkan M ve ark. Sivas’ta Alan Taramasıyla Yanık İnsidansının Araştırılması. Türkiye Klinikleri Journal of MedSciences 2010; 30(5): 1552-60.
31. Kamboj A, Chounthirath T, Xiang H, Smith GA. Traumatic brain injuries associated with consumer products at home among US children younger than 5 years of age. Clin Pediatr (Phila). 2017; 56: 545-54.
32. Bendçi B, Uysal G. Retrospective Evaluation of Pediatric Patients monitored with Trauma in Emergency Service: Three-Years Evaluation ArchHealthSciRes 2020; 7(2): 123-8.
33. Schneier AJ, Shields BJ, Hostetler SG, Xiang H, Smith GA. Incidence of pediatric traumatic brain injury and associated hospital resourceutilization in the United States. Pediatrics. 2006; 118(2): 483-92.
34. Chua KS, Ng YS, Yap SG, Bok CW. A Brief Review of Traumatic Brain Injury Rehabilitation. AnnAcadMedSingapore. 2007; 36(1): 31-42.
35. Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012; 380(4): 499-505.
36. Rajaraman P, Simpson J, Neta G, Berrington de Gonzalez A, Ansell P, Linet MS et al. Early life exposure to diagnostic radiation and ultrasound scans and risk of childhood cancer: case control study. BMJ. 2011; 10: 342.
37. Spady DW, Saunders DL, Schopflocher DP, Svensson LW. Patterns of injury in children. Pediatrics 2004; 113(3): 522-9.
38. Zümrüt M. Acil Servise Başvuran Çocuklarda Kırıkların Epidemiyolojik Değerlendirmesi. Kocatepe tıp dergisi. 2014; 15(2): 142-46.
39. Schalamon J, Dampf S, Singer G,Georg MD, Petnehazy AH, Thomas H, et al. Evaluation offractures in children and adolescents in a level 1 trauma center in Austria. J Trauma 2011; 71(2): 19-25.
40. Halsey MF. Pediatric pulled elbow injury: more common and recurrent than you think. Acta Pediatr 2019; 107(11): 1850.
41. Ohbuchi H, Hagiwara S, Hirota K, Koseki H, Kuroi Y, Arai N, et al. Clinical predictors of intracranial injuries in infants with minor head trauma. World Neurosurg. 2017; 98: 479-83.
42. Şahin S, Doğan Ş, Aksoy K. Çocukluk çağı kafa travmaları. Uludağ Tıp Derg. 2002; 28(2): 45-51.
43. Mtaweh H, Bell MJ. Management of pediatric traumatic brain injury. Curr Treat Options Neurol. 2015; 17: 348.

Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Acil Tıp
Bölüm	Araştırma Makalesi
Yazarlar	Mustafa Alpaslan 0000-0003-3170-0125
Yayımlanma Tarihi	30 Nisan 2024
Gönderilme Tarihi	10 Ağustos 2023
Yayımlandığı Sayı	Yıl 2024 Cilt: 16 Sayı: 1

Kaynak Göster

Vancouver	Alpaslan M. Acil servise başvuran iki yaş altındaki travma vakalarının analizi ve radyolojik görüntüleme oranlarının değerlendirilmesi. Maltepe tıp derg. 2024;16(1):15-20.

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