Ulus Travma Acil Cerrahi Derg. 2008; 14(2): 125-131

Motorlu araç kazalarýnda yaralanan travma hastalarý ile ilgili hastane mortalitesi tahminleri

Haridimos Markogiannakis¹, Elias Sanidas¹, Evangelos Messaris², Dimitrios Koutentakis³, Kalliopi Alpantaki⁴, Alexandros Kafetzakis⁵, Dimitrios Tsiftsis^1
1Girit Üniversitesi, Herakleion Týp Fakültesi, Herakleion Üniversite Hastanesi, Cerrahi Onkoloji Kliniði, Girit, Yunanistan
²Atina Üniversitesi, Atina Týp Fakültesi, Hipokrat Hastanesi, 1. Cerrahiye Giriþ Kliniði, Atina, Yunanistan
³Girit Üniversitesi, Herakleion Týp Fakültesi, Herakleion Üniversite Hastanesi, Nöroþirürji Kliniði, Herakleion, Girit, Yunanistan
⁴Girit Üniversitesi, Herakleion Týp Fakültesi, Herakleion Üniversite Hastanesi, Ortopedi Ve
⁵Girit Üniversitesi, Herakleion Týp Fakültesi, Herakleion Üniversite Hastanesi, Kalp-damar Cerrahisi Kliniði, Herakleion, Girit, Yunanistan

AMAÇ
Motorlu araç kazalarýnda yaralanan travmalý hastalarla ilgili hastane mortalitesi tahminleri deðerlendirildi.
GEREÇ VE YÖNTEM
Yunanistan’ýn Girit kentinde 1. basamak travma merkezi olan Herakleion Üniversitesi Hastanesi’nin travma kayýtlarý deðerlendirilerek, 1997 ile 2000 yýllarý arasýnda motorlu araç kazasý nedeniyle yatýrýlan eriþkin 730 travma hastasý ardýþýk olarak çalýþmaya dahil edildi. Hastalarýn cinsiyet, yaþ, yaralanma mekanizmasý, beher anatomik bölge baþýna yaralanma, baþlangýç vital bulgularý, Glasgow Koma Skalasý (GKS), yaralanma ciddiyet skoru (ISS) ve nihai sonuçlarý analiz edildi. Kesintisiz deðiþkenleri daha iyi tanýmlamak için iki kategori oluþturuldu: ≥60 ve <60 yaþ, ≥18 ve <18 ISS.
BULGULAR
Mortalite oraný %4,8 bulundu (n=35). Çok deðiþkenli saðkalým analizi sonuçlarý: yaþ ≥60 (p=0,0002), ≥18 ISS (p=0,003), yaya olma durumu (p=0,007), kraniyoserebral yaralanmalarda (p=0,01), torasik (p=0,01) ve abdominal yaralanmalarda (p=0,01), hastalarýn hastane mortalitelerine iliþkin baðýmsýz tahminlerdi.
SONUÇ
Motorlu taþýt kazalarýnda, yaþý ≥60, yaya olan, ISS ≥18, kranyoserebral, torasik veya karýn yaralanmasý olan travma hastalarý hastanede hayatýný kaybetme sonucu bakýmýndan yüksek risk altýndadýrlar.

Anahtar Kelimeler: Hastanede mortalite, motorlu taþýt kazalarý; tahmin faktörleri; travmalý hastalar.

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Predictors of in-hospital mortality of trauma patients injured in vehicle accidents

Haridimos Markogiannakis¹, Elias Sanidas¹, Evangelos Messaris², Dimitrios Koutentakis³, Kalliopi Alpantaki⁴, Alexandros Kafetzakis⁵, Dimitrios Tsiftsis^1
1Department Of Surgical Oncology, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece
²1st Department Of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University Of Athens, Athens, Greece
³Department Of Neurosurgery, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece
⁴Department Of Orthopaedics, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece
⁵Department Of Thoracic And Vascular Surgery, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece

OBJECTIVES
Identification and assessment of predictive factors of in-hospital mortality of trauma patients injured in vehicle accidents.
METHODS
We reviewed the Trauma Registry data of Herakleion University Hospital, a level I trauma center in Crete, Greece. All 730 consecutive, adult motor-vehicle trauma patients admitted to our hospital from 1997 to 2000 were included in the study. Variables included in the analysis were: sex, age, mechanism of injury, injuries per anatomic region, initial vital signs, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and the final outcome. In order to better describe continuous variables, two categories were created: age ≥60 and <60; ISS ≥18 and <18.
RESULTS
Mortality rate was 4.8% (n=35). Multivariate survival analysis showed that age greater than or equal to 60 years (p=0.0002), ISS greater than or equal to 18 (p=0.003), being a pedestrian (p=0.007), craniocerebral injuries (p=0.01), thoracic (p=0.01), and abdominal injuries (p=0.01) are independent predictors of the in-hospital mortality of the patients.
CONCLUSION
Trauma patients after vehicle accidents aged ≥60, pedestrians, those with an ISS ≥18 and craniocerebral, thoracic or abdominal injuries are at higher risk of an in-hospital fatal outcome.

Keywords: In-hospital mortality, predictive factors; trauma patients; vehicle accidents.

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