Evaluation of Demographic and Clinical Characteristics of Patients Presenting to the Emergency Department with Traffic Accidents

INTRODUCTION: Traffic accidents constitute an important part of the admission to the emergency department with trauma. The aim of this study; is to evaluate demographics, type of injury and our clinical approach of patients admitted to a third level education and research hospital after traffic accident in one year.
METHODS: The clinical data of patients who admitted to department of emergency medicine after a traffic accident between 1.1.2014 and 31.12.2014 date were evaluated. Patient’ s data was reached by using computer- based data recording system. Age and gender of the patients were evaluated. The type of accident, requested tests; blood tests, radiography, ultrasonography (USG), computed tomography (CT), focused assessment with sonography in trauma (FAST) by emergency physician were evaluated. Systems affected by the trauma were grouped in head and neck, thorax, abdomen, upper extremity and lower extremity. The count of affected systems were classified; single system, multiple systems and not affected system. The number of consultation based on branches was evaluated. The count of consultations were grouped; 1, 2, 3, 4 and more. The ending of the patients grouped as; hospitalization, referral, discharge and death. Clinics where patient was referred and clinics where patient was hospitalizated were evaluated.
RESULTS: 2492 patients were included in the study admitted to our clinic after a traffic accident in 2014. 1633 (66%) patients were male and 859 (34%) patients were female. The average age of the patients was calculated as 32.06 years. The 2492 patients in the study were 996 (40%) vehicle traffic accidents and 1496 (60%) nonvehicle traffic accidents.The count of affected systems were; 1413 (%26,7) patients single system, 916 (%36,8) patients multiple systems and 166 (%6,7) patients hasn’t affected system. 973 (39%) patients were affected from head and neck, 1119 (44.9%) patients from lower extremities, 765 (30.7%) patients from upper extremity, 338 (13.6%) patints from abdomen and 317 (12.7%) patients from the thorax. Count of consultations were in 1310 (%52,6) patients zero, in 904 (%36,3) patients one, in 103 (%4,1) patients two, in 26(%1) patients three and in 49 (%2) patients four and more. Most requested consultation branch was orthopedics. The ending of patients were in 177 (%7,1) patients hospitalization, in 2297 (%92,2) patients discharge, in 8 (%0,3) patients death and in 2 (%0,1) patients dispatch. The clinic that hospitalized most of the patients was ortopedics. According to the seasons cases there is a statistically significant difference between the incidence. According to this information improving and planning of emergency services should be continued.
DISCUSSION AND CONCLUSION: Traffic accidents plays an important role in the admission of emergency services. Consultation, laboratory tests and imaging hold an important place on process of the admission and discharge of patients. Public should be informed about pre-trauma prevention methods and appropriate trauma centers. Thereby earlier and more effective intervention could be provided for patients.

Trafik Kazasý ile Acil Servise Baþvuran Hastalarýn Demografik ve Klinik Özelliklerinin Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Acil servise travma nedeniyle olan baþvurularýn önemli bir kýsmýný trafik kazalarý oluþturmaktadýr. Çalýþmamýzýn amacý; bir yýl içinde üçüncü basamak bir eðitim araþtýrma hastanesi acil týp kliniðine trafik kazasý sonrasý baþvuran hastalarýn demografik özelliklerini, yaralanma tiplerini ve klinik yaklaþýmýmýzý deðerlendirmektir.
YÖNTEM ve GEREÇLER: Acil týp kliniðine 01.01.2014 ve 31.12.2014 tarihleri arasýnda trafik kazasý sonrasý baþvuran hastalarýn verileri deðerlendirildi. Hastanenin bilgisayar tabanlý veri kayýt sistemi kullanýlarak hastalarýn verilerine ulaþýldý. Hastalarýn yaþ ve cinsiyetleri deðerlendirildi. Kazanýn oluþ þekli, istenen tetkikler; kan tetkikleri, direkt grafi, ultrasonografi (USG), bilgisayarlý tomografi (BT), acil týp kliniðinde travmaya yönelik odaklanmýþ ultrasonografi (FAST) yapýlma sýklýðý deðerlendirildi. Travmadan etkilenen sistemler baþ boyun, toraks, batýn, üst ekstremite ve alt ekstremite olarak gruplandýrýldý. Etkilenen sistem sayýsý tek sistem, çoklu sistem ve etkilen sistem yok olarak gruplandýrýldý. Branþlara göre istenen konsültasyon sayýlarý deðerlendirildi. Vakalara istenen konsültasyon sayýlarý ise 1, 2, 3 ve 4 ve üzeri olarak gruplandýrýldý. Hastalarýn kliniðimizden ayrýlýþlarý yatýþ, sevk, taburcu ve ölüm olarak gruplandýrýldý. Hastalarýn yatýþ yapýldýðý klinikler ve sevk edildiði klinikler deðerlendirildi.
BULGULAR: 2014 yýlýnda kliniðimize trafik kazasý sonrasý baþvuran 2492 hasta çalýþmaya dâhil edildi. Hastalarýn 1633 ‘ü (%66) erkek, 859 ‘u (%34) kadýndý. Hastalarýn yaþ ortalamalarý 32,06 yýl olarak hesaplandý. Çalýþmaya alýnan 2492 hastanýn 996 ‘sý (%40) araç içi iken, 1496 ‘sý (%60) araç dýþý trafik kazasýydý. Hastalarýn 166’sýnda (%6,7) kazadan etkilenen sistem bulunmazken, 1413’ ünde (%56,7) etkilenen sistem sayýsý tek, 916’ sýnda (%36,8) çoktur. Hastalarýn 973’ ünde (%39) etkilenen sistem baþ ve boyun, 1119’ unda (%44,9) alt ekstremite, 765’ inde (%30,7) üst ekstremite, 338’ inde (%13,6) batýn ve 317’sinde (%12,7) torakstýr. Hastalarýn 1335’inde (%53,6) istenen tetkikler kan tetkiki, 1807’sinde (%72.5) röntgen, 1304’ ünde (%52.3) BT, 15’inde (%0.6) USG radyoloji ve 270’inde (%10.8) FAST acildir. Hastalarýn 1310’unda (%52.6) konsültasyon görülmezken, 904’ünde (%36.3) konsültasyon sayýsý 1, 103’ünde (%4.1) 2, 26’ sýnda (%1) ve 49’unda (%2) 4 ve üzeri görülmektedir. En çok konsültasyon istenen branþ ortopedidir. Hastalarýn 177’ si (%7.1) yatýþ, 2297’ sinde (%92.2) taburcu, 8’i (%0.3) ölüm ve 2’ si (%0.1) sevk nedeniyle takibi sonlanmýþtýr. En çok yatýþ yapýlan branþ ortopedidir. Mevsimlere göre vaka görülme oranlarý arasýnda istatistiksel olarak anlamlý farklýlýk bulunmaktadýr.
TARTIÞMA ve SONUÇ: Acil servis baþvurularý içinde trafik kazalarý önemli bir tutmaktadýr. Bu hastalarýn yatýþ ve taburculuk sürecinde ilgili branþ konsültasyonlarý, görüntüleme ve laboratuar tetkikleri önemli yer tutmaktadýr. Bu bilgiler ýþýðýnda acil servislerin planlanmasýna ve iyileþtirilmesine devam edilmelidir. Gerek halkýn travma öncesi önleme yöntemleri hakkýnda bilgilendirilmesi gerekse uygun merkezlere yönlendirilmesi için bilgilendirme çalýþmalarý yapýlmalýdýr. Böylece hastalara daha erken ve etkin müdahale saðlanabilecektir.