Acil servise başvuran hastalara çekilen abdomen bilgisayarlı tomografilerin değerlendirilmesinde acil tıp uzmanlık öğrencilerinin tomografileri yorumlamadaki doğruluk ve güvenilirlik derecelerinin araştırılması
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Date
2020
Authors
Cander, Sümeyye Tuğba Sarkı
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Acil servise başvuran travma hastalarında abdomen bilgisayar tomografi görüntülerini acil tıp asistanlarının değerlendirmesi, hastaların yönetiminde oldukça önemlidir. Yaptığımız bu çalışmada; acil serviste abdomen bilgisayar tomografi (BT) çekilen travma hastalarının, görüntülerinin yorumlanmasında acil tıp asistanlarının doğruluk ve güvenilirliğini araĢtırmayı amaçladık. Bu çalıĢmada Uludağ Üniversitesi Tıp Fakültesi Acil Servisi‟ne 4 Nisan 2019 - 4 Ekim 2019 tarihleri arasında travma ile başvuran ve abdomen patolojisi düĢünülerek abdomen bilgisayar tomografi çekilen 200 hastanın sonuçları prospektif olarak değerlendirildi. Acil servise travma ile başvuran hastaları acil servis asistanı karşıladı, vitalleri stabil olan hastalar fizik muayene sonrası, vitalleri anstabil olan hastalar ise stabillendikten sonra bilgisayarli tomografi çekilmesi için acil radyoloji ünitesine yönlendirildi. Abdomen bilgisayarlı tomografi acil radyoloji ünitesinde hep aynı cihazla çekildi. AraĢtırmada hastayı muayene eden acil tıp asistanlarının BT görüntülerini değerlendirmesi istendi. Karşılaştırma için kesin rapor olarak onaylanmış olan radyoloji uzman hekiminin raporu kabul edildi. Acil tıp asistanları ile radyoloji uzman hekim raporu karşılaştırıldı. İstatistiksel analizler IBM SPSS Statistics 22.0 programında yapıldı ve anlamlılık düzeyi p<0,05 olarak alındı. AraĢtırmada 200 hastanın BT‟si incelendi. Çalışma da travma sonucu oluşan BT görüntülerinde karaciğer laserasyonu, karaciğerde hematom, dalak laserasyonu, dalakta hematom, böbrek yaralanması, vasküler yaralanma, kemik fragmanlarında fraktür, batın içi serbest sıvı ve batın içi serbest hava değerlendirildi. ÇalıĢma sonucunda, acil tıp asistanlarının travma ile gelen hastaların abdomen BT‟sini yorumlamalarında %90.5 uyum oranı ile, iyi bir performans gösterdiği görüldü (p=0.648). Acil tıp asistanlarının çoğunlukla travma hastalarını karĢılayan ve tedavi eden ilk doktor olması ve travma hastalarında radyolojik tetkiklerin yorumlamasındaki performansı hayati vii öneme sahip olması, abdomen travma konusundaki uyumluluk oranının yüksekliğini açıklayabilir.
Evaluation of abdominal computed tomography (CT) images by emergency medicine residents (EMR) in trauma patients admitted to the emergency room is very important in the management of patients. We aimed to investigate the accuracy and reliability of emergency medicine residents in the interpretation of images of trauma patients with abdominal CT in the emergency department. In this study, the results of 200 patients who applied to Uludağ University Faculty of Medicine Emergency Service between April 4, 2019 and October 4, 2019 with trauma and who underwent abdominal CT considering the abdominal pathology were evaluated. Patients who were admitted to the emergency department with trauma were welcomed by the emergency physician, patients with stable vitals were referred to the radiology unit after physical examination, and patients with unstable vitals after stabilization were directed to the radiology unit for computed tomography. Abdomen computed tomography was always taken with the same device in the emergency radiology unit. Emergency medical residents who examined the patient in the study were asked to evaluate the CT images. The radiology specialist's report was accepted as the final report for comparison. Emergency medicine residents and a radiology specialist report were compared. Statistical analyzes were performed using IBM SPSS Statistics 22.0 program and the level of significance was accepted as p<0.05. In the study, CT of 200 patients were examined. In the study, liver laceration, liver hematoma, splenic laceration, hematoma in the spleen, kidney injury, vascular injury, fracture of bone fragments, intraabdominal free fluid and intraabdominal free air were evaluated on CT images resulting from trauma. ix As a result of the study, it was observed that emergency medicine assistants performed well in interpreting abdominal CT of patients with trauma, with a 90.5% agreement rate (p=0.648). The fact that emergency medicine assistants are mostly the first doctors to meet and treat trauma patients and their performance in interpreting radiological examinations in trauma patients is vital, may explain the high rate of compliance with abdominal trauma.
Evaluation of abdominal computed tomography (CT) images by emergency medicine residents (EMR) in trauma patients admitted to the emergency room is very important in the management of patients. We aimed to investigate the accuracy and reliability of emergency medicine residents in the interpretation of images of trauma patients with abdominal CT in the emergency department. In this study, the results of 200 patients who applied to Uludağ University Faculty of Medicine Emergency Service between April 4, 2019 and October 4, 2019 with trauma and who underwent abdominal CT considering the abdominal pathology were evaluated. Patients who were admitted to the emergency department with trauma were welcomed by the emergency physician, patients with stable vitals were referred to the radiology unit after physical examination, and patients with unstable vitals after stabilization were directed to the radiology unit for computed tomography. Abdomen computed tomography was always taken with the same device in the emergency radiology unit. Emergency medical residents who examined the patient in the study were asked to evaluate the CT images. The radiology specialist's report was accepted as the final report for comparison. Emergency medicine residents and a radiology specialist report were compared. Statistical analyzes were performed using IBM SPSS Statistics 22.0 program and the level of significance was accepted as p<0.05. In the study, CT of 200 patients were examined. In the study, liver laceration, liver hematoma, splenic laceration, hematoma in the spleen, kidney injury, vascular injury, fracture of bone fragments, intraabdominal free fluid and intraabdominal free air were evaluated on CT images resulting from trauma. ix As a result of the study, it was observed that emergency medicine assistants performed well in interpreting abdominal CT of patients with trauma, with a 90.5% agreement rate (p=0.648). The fact that emergency medicine assistants are mostly the first doctors to meet and treat trauma patients and their performance in interpreting radiological examinations in trauma patients is vital, may explain the high rate of compliance with abdominal trauma.
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Keywords
Acil tıp asistanları, Abdomen BT, Travma, Güvenilirlik, Emergency doctors, Abdominal CT, Trauma, Reliability
Citation
Cander, S. T. S. (2020). Acil servise başvuran hastalara çekilen abdomen bilgisayarlı tomografilerin değerlendirilmesinde acil tıp uzmanlık öğrencilerinin tomografileri yorumlamadaki doğruluk ve güvenilirlik derecelerinin araştırılması. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.