GER�ATR�K TRAVMADA MORTAL�TE VE MORB�D�TEYE ETK� EDEN FAKT�RLER

�zdo�an, Mehmet; A�alar, Fatih; Daphan, �a�atay E; Topalo�lu, Serdar; �skender, Metin �akmak��

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H�zl� Arama

GER�ATR�K TRAVMADA MORTAL�TE VE MORB�D�TEYE ETK� EDEN FAKT�RLER [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 1999; 5(3): 189-193

GER�ATR�K TRAVMADA MORTAL�TE VE MORB�D�TEYE ETK� EDEN FAKT�RLER

Mehmet �zdo�an¹, Fatih A�alar¹, �a�atay E Daphan¹, Serdar Topalo�lu¹, Metin �akmak�� skender¹
Hacettepe �niversitesi T�p Fak�ltesi Genel Cerrahi

Ama�: Bu �al��man�n amac� geriatrik travma olgular�nda mortalite ve morbiditeye etki eden fakt�rlerin ortaya konmas�d�r. Metod: 318ya�l� �oklu yaralanmal� olgu; yaralanma mekanizmas�n�n, altta yatan hastal��n, Yaralanma A��rl�� Skorunun (ISS), D�zeltilmi� Travma Skorunun (RTS) sonuca etkisi bak�m�ndan incelenmi�tir. Bulgular: Ya��n mortalite ve komplikasyon oran�na etki etmedi�i, ancak sekeli etkiledi�i belirlenmi�tir. �l�me en �ok neden olan yaralanma mekanizmas�n�n d��me oldu�u saptanm��t�r. Kardiyovask�ler hastal�k d��ndaki altta yatan hastal�klar�n varl�� mortalite, komplikasyon oran�n� ve hastanede kal�� s�relerini etkilemedi�i saptanm��t�r. Komplikasyon geli�iminin sekeli, yo�un bak�mda ve hastanede kal�� s�resini art�rd�� g�zlenmi�tir. Takip edilebilen 133 hastan�n %57.9'unda sekel bulunmu�tur. ISS ve RTS mortaliteyi belirlemede �nemli bulunurken; BS ayn� zamanda sekeli belirlemek a��s�ndan da �nemli bulunmu�tur. Mekanik ventilasyon ve kan transf�zyonu yap�lanlarda mortalitenin artt�� g�zlenmi�tir.Sonu�: ISS, RTS, yaralanma mekanizmas� (d��meler), ba�vuru s�ras�nda �ok varl��, kafa travmas�, transf�zyon ve mekanik ventilasyon mortaliteyi art�rmaktad�r. �leri ya�, komplikasyon geli�imi ve ISS ise sekel riskini belirlemede �nemli bulunurken, hastanede kal�� s�resi uzunlu�u yaln�zca komplikasyon geli�imi ile ili�kili bulunmu�tur.

Anahtar Kelimeler: TRAVMA, ISS, RTS, SEKEL, GER�ATR�

FACTORS EFFECTING MORTALITY AND MORBIDITY IN THE TRAUMA IN THE ELDERLY

Mehmet �zdo�an¹, Fatih A�alar¹, �a�atay E Daphan¹, Serdar Topalo�lu¹, Metin �akmak�� skender¹
Hacettepe �niversitesi T�p Fak�ltesi Genel Cerrahi

Aim: To evaluate the factors effecting morbidity and mortality in geriatric trauma patients. Method: 318 elderly patients with multiple injuries were evaluated to analyse the effects of injury mechanism, preexisting disease, Injury Severity Score (ISS), Revised Trauma Score (RTS) on outcome. Results: Age was not found to be a factor on mortality and complication, while it increased disability. Falls were the mechanism mostly associated with the mortality. We found that preexisting chronic illnesses other than cardiovascular diseases were not significantly related to mortality, complication and hospital stay. Complication increased disability, ICU stay and hospital stay. Disability was found in 57.9% of the 133 patients followed. ISS and RTS were predictors of survival and ISS was also a good predictor of disability. The mortality increased with blood transfusion and mechanical ventilation. Conclusion: ISS, RTS, injury mechanism (falls), shock at the admission, head injury, transfusion and mechanical ventilation significantly predict mortality. Age, complication and ISS are related to disability. Complication is the only factor related to a prolonged hospital stay.

Keywords: TRAUMA, INJURY SEVERITY SCORE, REVISED TRAUMA SCORE, DISABILITY, ASSAULT, ELDERLY

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