TRAVMATÝK DÝYAFRAGMA RÜPTÜRLERÝNDE MORTALÝTEYE ETKÝLÝ PROGNOSTÝK FAKTÖRLER

PROGNOTIC FACTORS EFFECTING MORTALlTY IN TRAUMATIC DIAPHRAGMA INJURY

BACKGROUND: Traumatic diaphragma rupturesare difficult to diagnose and generally with associated organe injuries. The aim ofthe study is to evaluate the factors effect on mortality.
METHODS: Twenty-three patients with traumatic diaphragma injuries, admitted to our hospital were retrospectively evaluated for demographics, diagnosis, otherorgan injuries, treatment, mortalityand morbidity.
RESULTS: All patients were male and the mean age was 24.7± 10.0. The diaphragma injuries were observed during laparatomy in 19 patients (%82.6), during laparatomy and thoracotomy in 2 (%8.7). The injuries were diagnosed with fluid drainage from thorax tube during peritoneal lavage in 2 patients (%8. 7). All patients, but one, had other organ injuries (%95.7), most commonly in stomach, spleen and liver. Seven patients died during peroperative or postoperative peiod (%30.4). When these seven patients were compared to survived patients, it was observed that age and trauma score were statistically related to mortality rate (p<0.05), but the lenght ofthe diaphragmatic injury was not related to mortality rate (p > 0.05).
Conclusion: Traumatic diaphragma injuries are generally diagnosed during laparatomy and associated with other organ injuries. The high mortality rate in patients with traumatic diaphragma injuries, is not related to the characteristics ofthe diaphragma injury, but it is closely related to concomitant problems such as patient is age and trauma score.