Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes
Yıl: 2019 Cilt: 25 Sayı: 1 Sayfa Aralığı: 46 - 54 Metin Dili: İngilizce DOI: 10.5505/tjtes.2018.97345 İndeks Tarihi: 10-06-2020
Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes
Öz: BACKGROUND: Multiple traumas are a leading cause of mortality among young adults worldwide. Thoracic trauma causes approximately 25% of all trauma-associated deaths. This study aims to determine the independent prognostic factors of mortality in cases withthoracic trauma (isolated or with accompanying organ injuries) who were admitted to the intensive care unit (ICU).METHODS: We retrospectively reviewed data from patients with thoracic trauma who were admitted to our ICU between 2007and 2016. After excluding pediatric patients (aged <18 years), the study sample included 564 cases. From the records, we collectedthe patients’ demographical data, comorbid diseases, primary trauma as an indication for ICU admission, other traumas accompanyingthoracic trauma, type of thoracic injury, and therapeutic interventions. The study sample was divided into two subsets: survival andnon-survival groups. These two groups were compared with regards to first ICU day laboratory results and intensive care scores,mechanical ventilation times, and ICU stay lengths.RESULTS: Of the 8063 patients admitted to the ICU between 2007 and 2016, 616 (7.6%) had thoracic trauma. The median age(min–max) of the 564 patients eligible for this study was 43 (18–87) years. Mortality occurred in 159 (28.1%) cases, while 405 (71.8%)were discharged from the ICU. Multivariate regression analyses were also performed, in which every increment in age was associatedwith a 1.025-fold increase in the odds of mortality due to thoracic trauma. Additionally, the presence of central nervous system (CNS)trauma was associated with a 2.147-fold increase, and the presence of pulmonary contusion was associated with a 1.752-fold increase.CONCLUSION: Results of this study indicate that advanced age, the presence of pulmonary contusion, and accompanying CNStrauma are independent predictors of mortality in patients with thoracic trauma in the ICU. Our non-invasive approach is further supported by the trauma and injury severity score (TRISS) scoring system, which is one of the latest scoring systems used in trauma cases.
Anahtar Kelime: Yoğun bakım ünitesine başvuran toraks travmalı olguların prognostik değerlendirmesi: On yıllık sonuçlar
Öz: AMAÇ: Çoklu travmalar ülkemizde ve dünyada özellikle genç erişkinlerin ölüm nedenlerinin başında gelmektedir. Bu çalışmanın amacı yoğun bakımlarda takip edilmekte olan izole ya da diğer organ yaralanmaları ile birlikte olan toraks travmalı olgularda mortalite için bağımsız prognostik faktörlerinin predikte edilmesidir. GEREÇ VE YÖNTEM: Bu çalışmada, 2007–2016 yılları arasında yoğun bakım ünitemizde takip edilmiş olan toraks travmalı hastaların verileri geriye dönük olarak incelendi. Bu yıllar içerisinde yoğun bakım hasta kayıt sisteminde yer alan 8063 hasta arasından verilerine sağlıklı bir şekilde ulaşılan 616 toraks travma hastası saptandı. On sekiz yaş altı olgular dışlanarak kalan 564 hasta çalışma grubu hastası olarak belirlendi. BULGULAR: Çalışmaya alınan 8063 hastanın 616’sında (%7.6) toraks travması saptandı. Çalışma kriterlerini sağlayan 564 çalışma grubu hastasının yaş ortalaması medyan (min-maks) 43 (18–87) idi. Hastaların 159’u (%28.1) mortalite ile sonlanırken 405’i (%71.8) yoğun bakım ünitesinden taburcu edildi. Travma ve Yaralanma Şiddeti Skoru’nun (TRISS) mortalite takibi için, AUC değeri: 0.922 (%95 CI: 0.899–0.946) idi. ROC analizine göre mortalite gelişme olasılığı için TRISS skoru 59.93 sınır kabul edildiğinde (Sensitivite; 0.88, Spesifisite: 0.87) olarak tespit edildi. Multivaryant lojistik regresyon analizinde mortaliteyi ön görmede her bir yaş artış mortalitede 1.025 kat, santral sinir sistemi travması varlığı mortalitede 2.147 kat, pulmoner kontüzyo varlığı mortalitede 1.752 kat artışla ilişkiliydi. TARTIŞMA: Bu çalışmanın sonuçları ile toraks travma hastalarında ileri yaş, pulmoner kontüzyon ve eşlik eden santral sinir sistemi travması yoğun bakım mortalitesini göstermede bağımsız birer risk faktörü olarak tanımlanmıştır. Travma hastalarında en güncel skorlama sistemlerinden olan TRISS skoru da bu non-invaziv yaklaşımımızı desteklemektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | PEHLİVANLAR KÜÇÜK M, KÜÇÜK A, AKSOY İ, AYDIN D, Ülger F (2019). Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. , 46 - 54. 10.5505/tjtes.2018.97345 |
| Chicago | PEHLİVANLAR KÜÇÜK Mehtap,KÜÇÜK Ahmet Oğuzhan,AKSOY İskender,AYDIN DAVUT,Ülger Fatma Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. (2019): 46 - 54. 10.5505/tjtes.2018.97345 |
| MLA | PEHLİVANLAR KÜÇÜK Mehtap,KÜÇÜK Ahmet Oğuzhan,AKSOY İskender,AYDIN DAVUT,Ülger Fatma Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. , 2019, ss.46 - 54. 10.5505/tjtes.2018.97345 |
| AMA | PEHLİVANLAR KÜÇÜK M,KÜÇÜK A,AKSOY İ,AYDIN D,Ülger F Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. . 2019; 46 - 54. 10.5505/tjtes.2018.97345 |
| Vancouver | PEHLİVANLAR KÜÇÜK M,KÜÇÜK A,AKSOY İ,AYDIN D,Ülger F Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. . 2019; 46 - 54. 10.5505/tjtes.2018.97345 |
| IEEE | PEHLİVANLAR KÜÇÜK M,KÜÇÜK A,AKSOY İ,AYDIN D,Ülger F "Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes." , ss.46 - 54, 2019. 10.5505/tjtes.2018.97345 |
| ISNAD | PEHLİVANLAR KÜÇÜK, Mehtap vd. "Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes". (2019), 46-54. https://doi.org/10.5505/tjtes.2018.97345 |
| APA | PEHLİVANLAR KÜÇÜK M, KÜÇÜK A, AKSOY İ, AYDIN D, Ülger F (2019). Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. Ulusal Travma ve Acil Cerrahi Dergisi, 25(1), 46 - 54. 10.5505/tjtes.2018.97345 |
| Chicago | PEHLİVANLAR KÜÇÜK Mehtap,KÜÇÜK Ahmet Oğuzhan,AKSOY İskender,AYDIN DAVUT,Ülger Fatma Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. Ulusal Travma ve Acil Cerrahi Dergisi 25, no.1 (2019): 46 - 54. 10.5505/tjtes.2018.97345 |
| MLA | PEHLİVANLAR KÜÇÜK Mehtap,KÜÇÜK Ahmet Oğuzhan,AKSOY İskender,AYDIN DAVUT,Ülger Fatma Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. Ulusal Travma ve Acil Cerrahi Dergisi, vol.25, no.1, 2019, ss.46 - 54. 10.5505/tjtes.2018.97345 |
| AMA | PEHLİVANLAR KÜÇÜK M,KÜÇÜK A,AKSOY İ,AYDIN D,Ülger F Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(1): 46 - 54. 10.5505/tjtes.2018.97345 |
| Vancouver | PEHLİVANLAR KÜÇÜK M,KÜÇÜK A,AKSOY İ,AYDIN D,Ülger F Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(1): 46 - 54. 10.5505/tjtes.2018.97345 |
| IEEE | PEHLİVANLAR KÜÇÜK M,KÜÇÜK A,AKSOY İ,AYDIN D,Ülger F "Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes." Ulusal Travma ve Acil Cerrahi Dergisi, 25, ss.46 - 54, 2019. 10.5505/tjtes.2018.97345 |
| ISNAD | PEHLİVANLAR KÜÇÜK, Mehtap vd. "Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes". Ulusal Travma ve Acil Cerrahi Dergisi 25/1 (2019), 46-54. https://doi.org/10.5505/tjtes.2018.97345 |
