FACTORS AFFECTING TREATMENT AND MORTALITY IN CASES WITH LOWER CERVICAL SPINAL TRAUMA

In the study, we investigated a total of 43 cases with lower cervical spinal injury, admitted and treated at the Department of Neurosurgeiy, Research Hospital of Medical Faculty, Dicle University, between 1990-1996. Of 43 patients whose ages varied between 10-66,32 (74.4%) were male and 7 I (25.6%) were female. Of these patients, 24 (55.8%) applied to our clinic due to fall-down, 11 (25.5%) traffic accident, 8 (18.6%) gun-shot injury. Seventeen of the cases (39.5%) died. In our study, the factors affecting mortality in cervical spinal injuries leading to high mortality and morbidity were investigated. Lesions were imaged first by direct radiography and later by computerized tomography. The results of this study demonstrated that such factors as patients age, existence of neuro-deficits, presence of additional traumatic pathologies, lack of training in primary health care units on this matter, transfer under inadequate conditions, delay of diagnosis and proper intervention affected mortality and morbidity in this type of injuries.

ALT SERVÝKAL SPÝNAL TRAVMALI OLGULARDA TEDAVÝ VE MORTALÝTEYÝ ETKÝLEYEN FAKTÖRLER

Bu çalýþmada Dicle Üniversitesi Týp Fakültesi Araþtýrma Hastanesi Nöroþirurji Kliniðinde 1990- 1996 yýllarý arasýnda ki 6 yýllýk bir süre içerisinde yatýrýlarak tedavi edilen (C4 altý) alt servikal spinal yaralanmasý olan 43 olgu incelendi. Yaþlarý 10-66 arasýnda deðiþen 43 olgunun 32'si (% 74,4) erkek, 11'i (%25,6) bayandý. Bu 43 hastanýn 24'ü (%55,8) düþme, 11'i (%25,5) trafik kazasý, 8'i (%18,6) ateþli silah yaralanmasý sonucu baþvuranlardý. Olgularýn 17si (%39,5) ölümle sonuçlanmýþtýr. Çalýþmamýzda yüksek mortalite ve morbiditeye neden olan servikal spinal yaralanmalarda mortaliteyi etkileyen faktörler incelendi. Lezyonlar önce direkt grafilerle, sonra bilgisayarlý tomografi ile görüntülendi. Sonuç olarak bu tip yaralanmalarda tedaviye ve mortaliteye etki eden faktörlerin; hastalarýn yaþlarý, nörodefisitlerinin varlýðý, ilave travmatik patolojilerinin olmasý, alt birim saðlýk istasyonlarýnda bu konuda eðitim eksikliði, uygun olmayan koþullarda transfer, taný ve uygun müdahalelerinin gecikmesi gibi faktörlerin tedaviyi ve mortaliteyi etkilediði saptandý.