Journals / SDÜ Tıp Fakültesi Dergisi / 2019 / Cilt: 26 - Sayı: 2

Postoperative mortality following civilian firearms injury during war: A retrospective cohort study

Savaş sırasında sivil ateşli silah yaralanmalarını takiben ortaya çıkan mortalite: Retrospektif bir kohort araştırması

Pages
131–140
Publication Date
2019-06-01
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall mortality was 11.3%; however, the mortality of patients was 8.1%, 40.3%, and 40.3% in groups A2, C, and D, respectively.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background: This study aims to identify factors affecting mortality following surgery for civilian firearms injuries using surgical classification as a surrogate marker of injury severity.
📊
Key Findings & Data:Methods: This was a retrospective study of patients who underwent surgery at a tertiary university hospital in Turkey between 2011 and 2014.
💡
Conclusion & Impact:Overall mortality was 11.3%; however, the mortality of patients was 8.1%, 40.3%, and 40.3% in groups A2, C, and D, respectively.
🔬Design:Modeling & Simulation
📍Scope:2011 Verileri
⚙️Variables:ateşli silah yaralanması · postoperatif mortalite · savaş yaralanması

Abstract

Background: This study aims to identify factors affecting mortality following surgery for civilian firearms injuries using surgical classification as a surrogate marker of injury severity. Methods: This was a retrospective study of patients who underwent surgery at a tertiary university hospital in Turkey between 2011 and 2014. All patients had sustained firearms injury and had an American Society of Anesthesiologists score of I-II. A grading system defined by the Communiqué on Health Practices in Turkey was used based on the surgery type and anesthetic procedure to determine the severity of injury and its relation with patient outcome (survival or death). Results: The median duration of hospital stay of patients who were discharged post healing was significantly longer than those who died [12 (0–559).vs 7.5 (0–468) days, respectively]. Overall mortality was 11.3%; however, the mortality of patients was 8.1%, 40.3%, and 40.3% in groups A2, C, and D, respectively. Healing in groups A2, C, and D was 2.4%, 54.1% and 25.8%, respectively. Independent variables affecting the coefficient of patient discharge status for sex, age, and surgical groups A2, C, and D were found to be significant. Conclusion: There was an association between the surgical groups and the firearms injuries sustained by civilians. Moreover, the coefficients associated with surgical group in our model may help predict the mortality risk in similar populations.

Özet

Amaç: Bu çalışma savaş yaralanması nedeni ile ameliyat edilen hastalar arasında, cerrahi grupların sınıflandırmasını yaralanma şiddetinin yerine kullanarak, mortaliteyi etkileyen faktörleri tanımlamayı amaçlamaktadır. Yöntem: Bu Türkiye’de bir üçüncü basamak üniversite hastanesinde 2011 ve 2014 yılları arasında ameliyata alınan hastalarda yapılan retrospektif bir çalışmadır. Tüm hastalar ateşli silah yaralanması nedeni ile ameliyata alınmış ve ASA skorları I–II idi. Yaralanmanın şiddetini ve hastanın son durumunu (sağ kalım veya ölüm) saptamak için cerrahinin tipi ve bununla ilişkili anestezi işlemine dayalı bir derecelendirme sistemi-Türkiye’de Sağlık Uygulamaları Tebliğinde tanımlandığı şekli ile- kullanıldı. İstatistiksel analiz sonuçları: Şifa ile taburcu olanların hastane süreleri ölenlerden anlamlı dercede daha uzundu [medyan (min-maks.) olarak sırası ile 12 (0-559).ve 7.5(0-468) gün]. Hastalar altı kategorik cerrahi gruba (A2, A3, B, C, D, ve E) dağılmıştı. Tüm mortalite %11.3 idi ancak A2, C, ve D gruplarında hastaların sırası ile %8.1, %40.3 ve %40.3’ü, ve şifa-sağ kalım yine A2, C, D grup hastalarda sırası ile %2.4, %54.1, %25.8 oranında idi. Hastanın son durumunu etkileyen bağımsız değişkenlerin cinsiyet, yaş ve cerrahi gruplardan A2, C ve D için katsayıları anlamlı idi. Sonuç: Cerrahi operasyon kategorileri ve sivil ateşli silah yaralanmaları arasında bir ilişki olduğu gözükmektedir, Dahası, modelimizdeki cerrahi grupları ile ilişkili katsayılar benzer populasyonlarda mortalite riskini tahmin etmeye yardımcı olabilir.

🔖

Cite This Article

OKŞAR, M., AKKURT, C., TURHANOGLU, S. (2019). Postoperative mortality following civilian firearms injury during war: A retrospective cohort study. SDÜ Tıp Fakültesi Dergisi, Cilt: 26 - Sayı: 2, 131–140. https://ajindex.com/articles/799507

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. Baker SP, O'Neill B, Haddon Jr W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma Acute Care Surg 1974;14:187-96
  2. Haider AH, Chang DC, Haut ER, Cornwell EE, 3rd, Efron DT. Mechanism of injury predicts patient mortality and impairment after blunt trauma. J Surg Res 2009;153:138-42
  3. Brown JB, Stassen NA, Bankey PE, Sangosanya AT, Cheng JD, Gestring ML. Mechanism of injury and special consideration criteria still matter: an evaluation of the National Trauma Triage Protocol. J Trauma Acute Care Surg 2011;70:38-44
  4. Newgard CD, Zive D, Holmes JF, Bulger EM, Staudenmayer K, Liao M, et al. A multisite assessment of the American College of Surgeons Committee on Trauma field triage decision scheme for identifying seriously injured children and adults. J Am Coll Surg 2011;213:709-21
  5. Pannell D, Poynter J, Wales PW, Tien H, Nathens AB, Shellington D. Factors affecting mortality of pediatric trauma patients encountered in Kandahar, Afghanistan. Can J Surg 2015;58:S141-5
  6. Aldrich EF, Eisenberg HM, Saydjari C, Foulkes MA, Jane JA, Marshall LF, et al. Predictors of mortality in severely head-injured patients with civilian gunshot wounds: a report from the NIH Traumatic Coma Data Bank. Surg Neurol 1992;38:418-23
  7. Ambrosi PB, Valença MM, Azevedo-Filho H. Prognostic factors in civilian gunshot wounds to the head: a series of 110 surgical patients and brief literature review. Neurosurg Rev 2012;35:429-43
  8. Aarabi B, Tofighi B, Kufera JA, Hadley J, Ahn ES, Cooper C, et al. Predictors of outcome in civilian gunshot wounds to the head. J Neurosurg 2014;120:1138-46
  9. Willis CD, Gabbe BJ, Jolley D, Harrison JE, Cameron PA. Predicting trauma patient mortality: ICD [or ICD-10-AM] versus AIS based approaches. ANZ J Surg 2010;80:802-6
  10. Clark DE, Hannan EL, Wu C. Predicting risk-adjusted mortality for trauma patients: logistic versus multilevel logistic models. J Am Coll Surg 2010;211:224-31
  11. Doornik JA, Hansen H. An omnibus test for univariate and multivariate normality. Oxf Bull Econ Stat 2008;70:927-39
  12. Belmont PJ Jr, McCriskin BJ, Sieg RN, Burks R, Schoenfeld AJ. Combat wounds in Iraq and Afghanistan from 2005 to 2009. J Trauma Acute Care Surg 2012;73:3-12
  13. Owens BD, Kragh JF Jr, Wenke JC, Macaitis J, Wade CE, Holcomb JB. Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. J Trauma Acute Care Surg 2008;64:295-99
  14. Kelly JF, Ritenour AE