Acil cerrahi yan�k �nitesinde tedavi edilen �ocuklarda ya�amsal tehlike tan�m�n�n ve ihmalin adli t�p a��s�ndan irdelenmesi

Aliustao�lu, S�heyla; �nce, Haluk; �nce, Nurhan; Yaz�c�, Y�ksel; Berber, Gurol; G�lo�lu, Recep

Cilt : 16 Say� : 2 Y�l : 2024

30/12Gelecek Say� Ar�iv Kapaklar Pop�ler Makaleler

ICMJE COI Form

H�zl� Arama

Acil cerrahi yan�k �nitesinde tedavi edilen �ocuklarda ya�amsal tehlike tan�m�n�n ve ihmalin adli t�p a��s�ndan irdelenmesi [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2010; 16(2): 170-173

Acil cerrahi yan�k �nitesinde tedavi edilen �ocuklarda ya�amsal tehlike tan�m�n�n ve ihmalin adli t�p a��s�ndan irdelenmesi

S�heyla Aliustao�lu¹, Haluk �nce², Nurhan �nce³, Y�ksel Yaz�c�¹, Gurol Berber¹, Recep G�lo�lu⁴
¹Adli T�p Kurumu, �stanbul
²�stanbul T�p Fak�ltesi Adli T�p Anabilim Dal�
³�stanbul T�p Fak�ltesi Halk Sa�l�� Anabilim Dal�
⁴�stanbul T�p Fak�ltesi Genel Cerrahi Anabilim Dal�, Travma Ve Acil Cerrahi Birimi

AMA�
�al��man�n amac�, acil servis yan�k �nitesinde tedavi edilen �ocuklar�n sosyo-demografik �zelliklerini ortaya koyarak, bu olgularda gerekli hekim yakla��m�n� tart��mak ve ya�amsal tehlike kriterleri ta��yan ve ta��mayan hastalar�n prognozlar�n� kar��la�t�rmakt�r.
GERE� VE Y�NTEM
�al��ma 14.10.2004 - 31.12.2006 tarihleri aras�nda, tan�mlay�c� epidemiyolojik y�ntemle, acil cerrahi servisi yan�k �nitesine gelen 0-18 ya� grubundaki olgularda (n=136) ger�ekle�tirilmi�tir. Haz�rlanan yar� yap�land�r�lm�� bir g�r��me formu ile yan�kl� hastalara ili�kin bilgiler toplanm��t�r. Veriler istatistiksel olarak de�erlendirilmi�tir.
BULGULAR
Olgular�n %66,2�si (n=90) erkek, %33,8�i (n=46) kad�nd�r. Ya� ortalamas� 3,9�4,1 y�l, ortalama yan�k y�zdesi 22,47�17,37 olarak hesaplanm��t�r. Yan�k nedenleri aras�nda ilk s�ray� %77,2 oranla (n=105) suda ha�lanmalar almaktad�r. Yan�k y�zdesi %20�nin alt�nda olan olgularda %6,3 (n=6) oran�nda, %20�nin �zerinde olan olgularda %61 (n=25) oran�nda �l�m g�r�lm��t�r (p=0,0001). I. derece yan�kl� olgular�n %21�inde (n=25) �l�m ger�ekle�irken, II.-III. derece yan�k olgular�n�n %35,3��nde (n=6) �l�m meydana gelmi�tir (p=0,189). Ya�amsal tehlike ta��yan olgularda �l�m oranlar�, ya�amsal tehlike ta��mayan olgularda kar��la��lan �l�m oranlar�ndan istatistiksel olarak anlaml�l�k g�sterecek bi�imde y�ksek bulunmu�tur (p=0,033).
SONU�
�ocuklarda yan�k y�zdesinin geni�li�i prognoz i�in �ok belirleyicidir. T�m yan�k olgular�n�n ihmal/istismar gibi de�erlendirilerek �ocuklar�n g�vence alt�na al�nmas� �nemli bir koruyucu hekimlik uygulamas� olacakt�r.

Anahtar Kelimeler: Adli t�p, �ocuk istismar�; yan�k nedenleri; yan�k travmalar�.

Evaluation of �life-threatening� definition and negligence in children treated in the emergency surgery service burn unit (from the viewpoint of forensic medicine)

S�heyla Aliustao�lu¹, Haluk �nce², Nurhan �nce³, Y�ksel Yaz�c�¹, Gurol Berber¹, Recep G�lo�lu⁴
¹Council Of Forensic Medicine Istanbul, Turkey
²Departments Of Forensic Medicine Istanbul Medical Faculty, Istanbul, Turkey
³Departments Of Public Health, Istanbul Medical Faculty, Istanbul, Turkey
⁴Departments Of General Surgery Trauma & Emergency Surgery Istanbul Medical Faculty, Istanbul, Turkey

BACKGROUND
The aim of this study is to outline the sociodemographic and traumatic characteristics of children who were referred to the Burn Unit of Emergency Service with burn injuries, to discuss the doctors� approach to these cases, and to compare the prognosis of patient groups with and without life-threat.
METHODS
This epidemiological study was carried out between 14 October 2004 and 31 December 2006 and included a total of 134 pediatric patients aged between 0-18 years. A semi-structured questionnaire form was designed to obtain the information from the study population. The obtained data were statistically evaluated.
RESULTS
66.2% (n=90) of the cases were male and 33.8% (n=46) were female. The mean age of the study population was 3.9�4.1 years and the mean percentage of burned body area was 22.47�17.37. The main cause of burn was scalding with hot water, with a frequency of 77.2% (n=105). When the percentage of burn area of the body was lower than 20%, the mortality was 6.3% (n=6), whereas it was 61% (n=25) when the burn area exceeded 20% of the body (p=0.0001). While the mortality was 21.0% (n=25) among the cases with first-degree burns, it was 35.3% (n=6) among those with second- and third-degree burns (p=0.189). Mortality ratio among the cases with life-threat was higher than those without life-threat, and this difference was statistically significant (p=0.033).

CONCLUSION
Extent of burn is a determinative factor for prognosis in children. Evaluation of all burn cases in children should be approached as cases of neglect/abuse; protection of these children in this manner will serve as an important practice of preventive medicine.

Keywords: Forensic medicine, child abuse; burn causes; burn traumas.

Sorumlu Yazar: Haluk �nce, T�rkiye
Makale Dili: T�rk�e

ATIF KOPYALA

Tam Metin PDF At�f dosyas� indir RIS EndNote BibTex Medlars Procite Reference Manager Yazara e-posta g�nder Benzer makaleler PubMed Google Scholar