Ulus Travma Acil Cerrahi Derg. 2011; 17(5): 450-454 | DOI: 10.5505/tjtes.2011.47124

Karýn içi ateþli silah yaralanmalarýnda komplikasyon oranlarýný etkileyen faktörler

Hüseyin Taþ¹, Ayhan Mesci², Mehmet Eryýlmaz³, Nazif Zeybek², Yusuf Peker^2
1Þýrnak Askeri Hastanesi Genel Cerrahi Kliniði, Þýrnak
²Gülhane Askeri Týp Akademisi Genel Cerrahi Anabilim Dalý, Ankara
³Gülhane Askeri Týp Akademisi Acil Týp Anabilim Dalý, Ankara

AMAÇ
Çatýþma bölgelerinde meydana gelen karýn içi ateþli silah yaralanmalarýnda (KASY) komplikasyon oranlarýný etkileyen faktörler deðerlendirildi.
GEREÇ VE YÖNTEM
Þubat 2002 - Mayýs 2005 tarihleri arasýnda yüksek kinetik enerjili KASY’li 21 hasta incelendi. Travma-hastane intervali, yaralanan karýn içi organ ve sayýsý, yaralanan ekstra-abdominal organ sayýsý, penetran abdominal travma indeksi (PATÝ) ve kan transfüzyonu miktarýnýn komplikasyon oranlarýna etkisi geriye dönük olarak deðerlendirildi.
BULGULAR
Hastalarýn %90,4’ünün ilk iki saat içerisinde transportu gerçekleþtirilerek ilk giriþimlerine baþlandý. Yaralanan organ sayýsý <3 olan hastalarda %7,1, ≥3 olanlarda ise %71 oranýnda komplikasyon geliþti (p<0,0001). Hastalarýn %71,4’ünde (n=15) izole karýn yaralanmasý, %28,6’sýnda (n=6) ek olarak ekstra-abdominal organ yaralanmasý vardý. PATÝ skoru <25 olan 13 hastada %7,7, ≥25 olan 8 hastada ise %62,5 oranýnda komplikasyon geliþtiði görüldü (p<0,0001). ≥3 Ü kan transfüzyonu yapýlan %47,6 (n=10) hastanýn %50’inde (n=5) komplikasyon tespit edildi (p<0,0001).
SONUÇ
Çalýþmamýzda KASY’de PATÝ skoru, multipl kan transfüzyonu ve yaralanan karýn içi organ sayýsý ameliyat sonrasý dönemde geliþebilecek komplikasyon oranlarýný etkileyen en önemli faktörlerken, travma-hastane intervali ile yaralanan ekstra-abdominal organ sayýsýnýn komplikasyon oranlarýna etkisi istatistiksel olarak anlamlý bulunmadý.

Anahtar Kelimeler: Ateþli silah yaralanmalarý, penetran karýn travma indeksi; komplikasyon oranlarý.

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The affecting factors on the complication ratio in abdominal gunshot wounds

Hüseyin Taþ¹, Ayhan Mesci², Mehmet Eryýlmaz³, Nazif Zeybek², Yusuf Peker^2
1Þýrnak Military Hospital General Surgery Department, Þýrnak, Turkey
²Gülhane Military Medical Academia General Surgery Department, Ankara, Turkey
³Gülhane Military Medical Academia Emergency Medicine Department, Ankara, Turkey

BACKGROUND
We aimed to investigate the affecting factors on the complication ratio in abdominal gunshot wounds.
METHODS
Twenty-one patients with abdominal gunshot wounds were analyzed between February 2002 and May 2005. The effects of the interval between trauma and presentation to the hospital, the number of injured abdominal and extra-abdominal organs, penetrating abdominal trauma index (PATI), and blood transfusion were evaluated.
RESULTS
90.4% of all patients were transported to the hospital and underwent their first evaluation in the first two hours. The complication rate was 7.1% in patients who had <3 injured organs and 71% in the others (p<0.0001). 71.4% of the patients had isolated abdominal trauma, while 28.6% had additional extra-abdominal organ trauma. The complication rate was 7.7% in 13 patients with PATI score <25 and 62.5% in 8 patients with a PATI score ≥25 (p<0.0001). In 10 patients who underwent blood transfusion of ≥3 units, the complication rate was 50% (p<0.0001).
CONCLUSION
In our study, PATI score, multiple blood transfusions and the number of injured intra-abdominal organs were the most important factors affecting the rate of postoperative complications in penetrating abdominal gunshot wounds. We found that the interval between trauma and presentation to the hospital and number of injured extra-abdominal organs did not affect the complication rate.

Keywords: Gunshot wounds, penetrating abdominal trauma index; complication rate.

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