DEPREMDE YARALANAN HASTALARA YAKLAÞIM: 17 AÐUSTOS 1999 MARMARA DEPREMÝ DENEYÝMÝMÝZ

Amacýmýz on yedi Aðustos 1999' da meydana gelen Marmara Depremi'nde Kartal Eðitim ve Araþtýrma Hastanesinin deneyimini aktarmaktýr. Deprem sonrasý 30 günlük zaman diliminde hastanemize baþvuran 698 yaralý, yaralanma þekilleri, yapýlan tedavi yaklaþýmlarý, morbidite ve mortalite açýsýndan analiz edildi. Yatan 273 hasta yaralanan majör organ sistemine göre sýnýflandýrýlýrken; crush yaralanmalar ayrý bir grupta sýnýflandýrýldý. En sýk görülen yaralanmalar crush yaralanma (%23.1), ekstremite kýrýklarý (%16.8) ve pelvis ve omurga kýrýklarý (%16.1) idi. En fazla yandaþ yaralanmanýn olduðu gruplar abdominal yaralanmalar (%45.5), crush yaralanmalarý (%24.4) ve pelvis ve omurga yaralanmalarý (%27.3) idi (p<0.05). Toplam mortalite % 7.3 idi. En sýk mortalite görülen gruplar abdominal yaralanmalar (%27.3) ve crush yaralanmalar (%20) oldu (p<0.05). Crush sendromlu hastalarýn %61.9'una daha sonra geliþen kompartman sendromuna baðlý olarak fasiyotomi yapýldý. 31 hastaya hemodializ uygulandý. Depremlerle ilgili olarak en önemli sorun, deprem sahasýnda, hastaneler arasýnda ve hastane içi organizasyon problemleridir. Yüksek oranda yandaþ travmasý olan hastalarda mortalite daha yüksek olmaktadýr. Depremde en fazla görülen yaralanma türü crush yaralanmadýr Erken taný, uygun ve hýzlý tedavi sað kalýmý artýrmaktadýr.

EVALUATION OF THE EARTHQUAKE VICTIMS: AUGUST THE 17TH, 1999 OUR EXPERIENCE IN THE MARMARA EARTHQUAKE

This study describes the experience of Kartal Research and Training Hospital in the Marmara Earthquake. We reviewed medical records of 698 patients admitted to our hospital in a 30 days' period after the earthquake and analysed the types of injuries, treatment, morbidity and mortality rates. The hospitalized 273 patients were grouped according to the major injury; patients with crash syndrome were analysed separately. The most frequent injuries were crush injury (23.1 %), extremity fractures (16.8 %) and pelvis and spine injuries (16.1%). More than two system injuries were seen most frequently in the abdominal injury (45.5%), crush injury (24.4%), and pelvis and spine injury (27.3%) groups (p < 0.05). Overall mortality rate was 7.3 %. The highest mortality rates were seen in the abdominal injury (27.3%) and crush injury (20%) groups (p<0.05). 61.9% of the patients with crush syndrome underwent fasciotomy due to the compartment syndrome; hemodialysis was performed in 31 patients. The most serious problem with earthquake is organization in the earthquake area, between hospitals and in hospitals. Crush injury is the major injury seen earthquakes. Early diagnosis and proper treatment should be done to improve survival,