Ulus Travma Acil Cerrahi Derg. 2010; 16(3): 260-267

An evaluation of the pediatric medico-legal admissions to a tertiary hospital emergency department

Mustafa Sever¹, Eylem Ulaþ Saz², Mehmet Koþargelir^3
1Department Of Emergency Medicine, Harran University, Sanliurfa, Turkey
²Department Of Pediatrics, Ege University, Izmir, Turkey
³Department Of Emergency Medicine, Haydarpasa Numune Trainning And Research Hospital, Istanbul, Turkey

BACKGROUND
This study aimed to determine the demographic and epidemiological characteristics and to investigate the outcomes of pediatric medico-legal cases who admitted to the emergency department. It was also aimed to contribute to the national survey.
METHODS
Medico-legal charts of the pediatric cases were reviewed retrospectively. Patients were allocated into two groups as traumatic (Group 1) and non-traumatic (Group 2). Age, sex, presenting complaint and frequencies, local or multiple trauma frequencies, and localizations (based on the Abbreviated Injury Scale) and also admission, discharge and mortality rates were ascertained. Data were evaluated by descriptive methods, Kolmogorov-Smirnov and chi-square tests. Values of p<0.05 were accepted as significant.
RESULTS
There were a total of 486 eligible patients. The mean age was 8.91±5.08 years (95% confidence interval [CI]). The majority (66.3%) were male. The group aged 5-9 years was larger (33.3%) than the others (in Kolmogorov-Smirnov test, p=0.000). Summer was the most common season for admissions. There were 153 patients in Group 1, and the most common complaint was accidental drug intake (13.8%). In Group 2, the most common reason for admission was motor vehicle accident (32.5%).
CONCLUSION
Motor vehicle and home accidents in childhood are preventable health problems. To ensure a safe environment, continuous health education programs on injury and prevention for parents and children and legal controls will be effective in injury control.

Keywords: Emergency department, medico-legal patient; pediatric patient; trauma.

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Bir üçüncü basamak hastane acil servisine baþvuran adli nitelikli çocuk hastalarýn deðerlendirilmesi

Mustafa Sever¹, Eylem Ulaþ Saz², Mehmet Koþargelir^3
1Harran Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Þanlýurfa
²Ege Üniversitesi Týp Fakültesi, Çocuk Saðlýðý Ve Hastalýklarý Anabilim Dalý, Ýzmir
³Haydarpaþa Numune Eðitim Ve Araþtýrma Hastanesi, Acil Týp Kliniði, Ýstanbul

AMAÇ
Çalýþmanýn amacý, bir üçüncü basamak hastane acil servisine baþvuran adli nitelikli çocuk hastalarýn, demografik, epidemiyolojik özelliklerini ve tedavi sonuçlarýný saptamak, ulusal verilerimize katkýda bulunmaktýr.
GEREÇ VE YÖNTEM
Adli nitelikli çocuk hastalarýn dosya bilgileri geriye dönük incelendi. Hastalar travmatik (Grup 1) ve travmatik olmayan (Grup 2) baþvurular olarak iki gruba ayrýldý. Yaþ, cinsiyet, baþvuru sebepleri ve sýklýklarý, lokal ve çoklu travma görülme sýklýðý (Kýsaltýlmýþ Yaralanma Ölçeði temel alýnarak) ve oluþtuðu vücut bölgeleri, yatýþ, taburculuk ve mortalite oranlarý gibi özellikleri kaydedildi. Veriler, tanýmlayýcý yöntemler (frekans, yüzde oran, çeyrekler arasý oran), Kolmogorov-Simirnov ve ki-kare testleri kullanýlarak deðerlendirildi, p deðeri <0,05 olan istatistiksel farklýlýklar anlamlý kabul edildi.
BULGULAR
Çalýþmaya 486 hasta dâhil edildi. Yaþ ortalamasý 8,91±5,08 yýl olarak saptandý (%95 GA). Hastalarýn çoðu erkekti (%66,3). Beþ-dokuz yaþ grubu hasta sayýsý (n=162, %33,3) diðerlerine oranla fazlaydý (Kolmogorov-Simirnov testinde p=0,000). Yaz baþvurularýn en sýk gözlendiði mevsimdi. Grup 1’de 153 (%31,5) hasta saptandý. En sýk baþvuru nedeni kazara ilaç içmeydi (%13,8, n=67). Grup 2’de en sýk baþvuru nedeni trafik kazasýydý (n=158, %32,5).
SONUÇ
Çocukluk çaðýnda motorlu araç ve ev kazalarý önlenebilir saðlýk sorunlarýnýn baþýnda yer almaktadýr. Güvenli bir çevre oluþturulmasý, ebeveyn ve çocuklara sürekli koruyucu saðlýk eðitimi verilmesi ve yasal düzenlemeler yaralanma kontrolünde etkin olacaktýr.

Anahtar Kelimeler: Acil servis, adli vaka; çocuk hasta; travma.

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