Journals / Ulusal Travma ve Acil Cerrahi Dergisi / 2016 / Cilt: 22 - Sayı: 5

Acil serviste akut künt travmatik aortik yaralanma tanısı alan olguların geriye dönükincelenmesi ve yatakbaşı akciğer grafi görüntülerinin değerlendirilmesi

Evaluation of patients diagnosed with acute blunt aortic injury and their bedside plain chest radiography in the emergency department: A retrospective study

Pages
449–456
DOI
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Appropriate further imaging studies should be carried out as appropriate based on patient's hemodynamic status

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Objective & Hypothesis:BACKGROUND: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury.METHODS: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study.
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Key Findings & Data:Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist.RESULTS: Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled.
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Conclusion & Impact:Appropriate further imaging studies should be carried out as appropriate based on patient's hemodynamic status
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

BACKGROUND: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury.METHODS: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist.RESULTS: Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled. Most common trauma mechanism was motor vehicle accident (53.3%). Agreement rates between emergency medicine specialists and radiologist were found to be "excellent" and "substantial" in identifying mediastinal widening and multiple left sided rib fractures; and "fair" in identifying widened paraspinal line, and transthoracic vertebral fractures.CONCLUSION: Though not completely reliable, bedside plain chest radiographs and physical examination findings may be useful in detecting aortic injury during primary survey when the patient is unstable and cannot be sent for chest computerized tomography. Appropriate further imaging studies should be carried out as appropriate based on patient's hemodynamic status

Özet

AMAÇ: Akut künt travmatik aortik yaralanması ile başvuran olguların geriye dönük olarak incelenmesi ve yatakbaşı akciğer grafisinde muhtemel aortik yaralanmaya ait bulgularının değerlendirilmesi amaçlandı.GEREÇ VE YÖNTEM: Beş yıllık dönemde 18 yaş üstü akut travmatik aort transeksiyonu tanılı hastanın dosyaları geriye dönük olarak incelendi. Demografik özellikleri, olayın niteliği, revise travma skoru, Glaskow koma skalası, vital bulguları, fizik muayene bulguları, biyokimyasal parametreleri, acilde kalış süreleri, olguların takip sonucu ve yatakbaşı çekilen akciğer grafisi iki acil tıp uzmanı ve bir radyolog tarafından değerlendirildi.BULGULAR: Çalışmaya 30 olgu alındı. Yaş ortalaması 45.87±16.14 (%70 erkek) ve en sık nedeni araçiçi trafik kazası (%53.3) idi. Acil tıp uzmanları ve radyolog uyumu mediastinal genişlemesi ve sol seri kot kırıklarında 'mükemmel-kabul edilebilir', paraspinal hattın genişlemesi ve torasik vertebra kırığında 'zayıf ' olarak tespit edildi.TARTIŞMA: Akut künt travmatik aortik yaralanma primer bakıda fizik muayene ve akciğer grafisi resüsitasyon için fikir verebilir. İkincil bakı için has-tanın hemodinamik stabilitesi ve yaralanma mekanizmaları da gözönüne alınarak uygun görüntüleme stratejileri belirlenmelidir.Anahtar sözcükler: Aortik transeksiyon; görüntüleme; travma; uyumluluk.

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Cite This Article

AKARCA, F. K., KORKMAZ, T., ÇINAR, C., ÇAKAL, E. D., ERSEL, M. (2016). Acil serviste akut künt travmatik aortik yaralanma tanısı alan olguların geriye dönükincelenmesi ve yatakbaşı akciğer grafi görüntülerinin değerlendirilmesi. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 22 - Sayı: 5, 449–456. https://ajindex.com/articles/324028

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