2011-2021 yılları arasında Bursa Uludağ Üniversitesi Tıp Fakültesi acil servisine fasiyal kemiklerde fraktür sebebi ile başvuran hastaların retrospektif analizi
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Date
2023
Authors
Bostancı, Nihal Akçalı
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Amaç: Bu çalışmada fasiyal yaralanma nedeniyle Acil Servise (AS) başvuran olguların klinik özellikleri ve klinik sonlanımları ile ilişkili parametrelerin belirlenmesi amaçlanmıştır. Metod: Kesitsel tipte olan bu çalışmada 2011-2021 yılları arasında Bursa Uludağ Üniversitesi AS’ne fasiyal yaralanma sebebi ile başvuran ve plastik rekonstrüktif ve estetik cerrahi anabilim dalına fasiyal kemiklerde fraktür sebebi ile konsülte edilen hastaların klinik özellikleri hastane kayıtlarından retrospektif olarak taranmıştır. Bulgular: Olguların %80,5’i erkekti, en sık travma nedenleri %26,1 darp, %25,7 düşme ve %14,0 araç içi trafik kazasıydı. En sık başvuru yaz aylarında yapılmıştı (%34,5). En sık yaralanan fasiyal kemikler %43,6 nazal kemik, %32,4 maksilla ve %31,8 orbitaydı. Olguların %72,6’sı taburcu edilirken, %14,3’ü kliniğe, %4,8’i YBÜ’ye yatırıldı, %3,7’si sevk edildi ve %0,3’ü eksitus oldu. Kadınlarda ateşli silah yaralanması, yüksekten düşme ve trafik kazaları kaynaklı travmalara maruz kalan olgular arasında YBÜ’ye yatış/eksitus sıklığı anlamlı düzeyde daha fazlaydı (p<0,05). Yaralanma saptanan fasiyal kemiğe göre YBÜ’ye yatış/ eksitus durumu sıklık sırasına göre şu şekildeydi: frontal (%19,0), orbita (%9,0), maksilla (%8,3), zigoma (%8,1), mandibula (%8,0) ve nazal (%3,6) kemik. Herhangi tipte fasiyal kemik fraktürü saptanması YBÜ’ye yatış/ eksitus ile ilişkili bulundu (p<0,05). Sonuç: Fasiyal yaralanmalı olgular daha çok erkeklerden oluşmakta, yaz aylarında, darp ya da düşme kaynaklı nazal fraktürle AS’e başvuru yapmaktadır. Kadınlar, daha yüksek enerjili travmaya maruz kalanlar ve fasiyal kemik fraktürü saptananlar arasında klinik sonlanım daha olumsuz olmaktadır. Bu özelliklere sahip olguların daha sıkı takip edilmesi ve erken dönemde uygun tedavinin sağlanması sağkalım ve sekel sıklığını azaltacak müdahaleler arasında değerlendirilebilir.
Aim: In this study, it was aimed to determine the parameters associated with the clinical features and clinical outcomes of patients who applied to the emergency department (ED) due to facial injury. Methods: In this cross-sectional study, the clinical features of the patients who applied to Bursa Uludağ University ED for facial injury and were consulted to the plastic reconstructive and aesthetic surgery department for fractures in the facial bones between 2011 and 2021 were retrospectively scanned from hospital records. Results: 80.5% of the cases were male, the most common causes of trauma were assault 26.1%, falling 25.7% and in-vehicle traffic accident 14.0%. The most frequent application was in the summer months (34.5%). The most frequently injured facial bones were 43.6% nasal bone, 32.4% maxilla and 31.8% orbit. While 72.6% of the cases were discharged, 14.3% were hospitalized to the clinic, 4.8% to the ICU, 3.7% were referred and 0.3% died. The frequency of hospitalization/exit to the ICU was significantly higher among women who were exposed to traumas caused by gunshot wounds, falling from a height, and traffic accidents (p<0.05). According to the facial bone in which the injury was detected, admission to the ICU/exitus status was as follows, in order of frequency: frontal (19.0%), orbit (9.0%), maxilla (8.3%), zygoma (8.1%), mandible (8.0%) and nasal (3.6%) bone. Detection of any type of facial bone fracture was found to be associated with ICU admission/exitus (p<0.05). Conclusion: The cases with facial injuries are mostly men, and they apply to the ED with nasal fractures caused by beatings or falling during the summer months. The clinical outcome is more unfavorable among women, those exposed to higher-energy trauma, and those with facial bone fractures. Closer follow-up of cases with these features and providing appropriate treatment in the early period can be considered among the interventions that will reduce survival and the frequency of sequelae.
Aim: In this study, it was aimed to determine the parameters associated with the clinical features and clinical outcomes of patients who applied to the emergency department (ED) due to facial injury. Methods: In this cross-sectional study, the clinical features of the patients who applied to Bursa Uludağ University ED for facial injury and were consulted to the plastic reconstructive and aesthetic surgery department for fractures in the facial bones between 2011 and 2021 were retrospectively scanned from hospital records. Results: 80.5% of the cases were male, the most common causes of trauma were assault 26.1%, falling 25.7% and in-vehicle traffic accident 14.0%. The most frequent application was in the summer months (34.5%). The most frequently injured facial bones were 43.6% nasal bone, 32.4% maxilla and 31.8% orbit. While 72.6% of the cases were discharged, 14.3% were hospitalized to the clinic, 4.8% to the ICU, 3.7% were referred and 0.3% died. The frequency of hospitalization/exit to the ICU was significantly higher among women who were exposed to traumas caused by gunshot wounds, falling from a height, and traffic accidents (p<0.05). According to the facial bone in which the injury was detected, admission to the ICU/exitus status was as follows, in order of frequency: frontal (19.0%), orbit (9.0%), maxilla (8.3%), zygoma (8.1%), mandible (8.0%) and nasal (3.6%) bone. Detection of any type of facial bone fracture was found to be associated with ICU admission/exitus (p<0.05). Conclusion: The cases with facial injuries are mostly men, and they apply to the ED with nasal fractures caused by beatings or falling during the summer months. The clinical outcome is more unfavorable among women, those exposed to higher-energy trauma, and those with facial bone fractures. Closer follow-up of cases with these features and providing appropriate treatment in the early period can be considered among the interventions that will reduce survival and the frequency of sequelae.
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Keywords
Acil servis, Fasiyal yaralanma, Klinik sonlanım, Emergency department, Facial injury, Clinical outcome
Citation
Bostancı, N. A. (2023). 2011-2021 yılları arasında Bursa Uludağ Üniversitesi Tıp Fakültesi acil servisine fasiyal kemiklerde fraktür sebebi ile başvuran hastaların retrospektif analizi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.