Acil servise travma nedeniyle başvuran erişkin hastalarda Ulusal Erken Uyarı Skoru (NEWS)'nun ve Revize Travma Skoru (RTS)'nun hasta sağkalım, sakatlık ve güvenli taburculuk açısından karşılaştırılması
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, acil servise travma nedeniyle başvuran 18 yaş üstü hastalarda NEWS ve RTS’nin; yatış, taburculuk kararı, sağ kalım ve sakatlığı ön görmelerinin anlamlılığının karşılaştırılması amacıyla yapılmıştır.
Gereç ve Yöntem: Prospektif ve kesitsel nitelikteki bu çalışmaya 11.06.2020-11.12.2020 tarihleri arasında, Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servise travma nedeniyle başvuran 18 yaş üstü hastalar dahil edilmiştir. Hastaların demografik verileri, başvuru mekanizmaları, yaşamsal bulguları, NEWS ve RTS değerleri, klinik sonlanımları, mortalite bulguları olgu rapor formu ile toplanmıştır.
Bulgular: Çalışmaya 404 hasta alınmıştır. Hastaların çoğunluğunun erkek, (n=284) ve çalışmada en sık görülen travma mekanizmasının (n=159) düşme olduğu görülmüştür. En sık görülen ek hastalık olarak (n=64) hipertansiyon saptanmıştır. Hastalar büyük oranda (n=289) taburcu olmuştur. Morbidite, diğer kliniğe yatış ve hastane yatışlarını ön görmede her iki skorlama sisteminin de kritik değer aralığında puanlama yaptığı ve birbirine yakın duyarlık ve özgüllüğe sahip olduğu saptanmıştır. 24. Saat ve 7. Gün mortalite ön görmede NEWS’in RTS’ ye göre klinik önemlilik açısından anlamlı bulguları olan bir değerlendirme aracı olduğu saptanmıştır.
Sonuç: Travma hastasının acil servislerde hızlı ve doğru bir şekilde yönetilmesi morbidite ve mortaliteyi etkileyen bir sağlık sorunudur. Travma Skorlama sistemleri bu açıdan oldukça önemlidir. Her iki değerlendirme skorlamasının karşılaştırılmasına ilişkin çalışmaların az olması, mortalite, morbidite ve yatış kararını ön görmede yapılan değerlendirmeleri kısıtlamaktadır. Bu nedenle daha fazla merkezde, uzun süreli randomize çalışmaların planlanması önerilmektedir.
Objective: In this study' aim, to compare of NEWS and RTS in patients over 18 years of age who applied to the emergency department due to trauma the significance of the predictions of admission, discharge decision, survival and disability. Materials and Methods: This prospective and cross-sectional study included patients over the age of 18 who were admitted to Ege University Faculty of Medicine Emergency Department due to trauma between 11.06.2020-11.12.2020. The demographic data of the patients, admission trauma mechanisms, vital signs, NEWS and RTS values, clinical outcomes, mortality findings were collected with a case report form. Results: 404 patients were included in the study. Most of the patients were male (n = 284), and the most common trauma mechanism in the study (n = 159) was falling. Hypertension was determined as the most common comorbidity (n = 64). Patients were mostly (n = 289) discharged. It was found that both scoring systems scored in the critical value range and had similar sensitivity and specificity in predicting morbidity, other clinic admissions and hospital admissions. NEWS was found to be an assessment tool with significant findings in terms of clinical significance compared to RTS in predicting 24th hour and 7th day mortality. Conclusion: The rapid and accurate management of the trauma patient in the emergency services is a health problem that affects morbidity and mortality. Trauma Scoring systems are very important in this respect. The scarcity of studies comparing both evaluation scores in literacy, limits the evaluations made in predicting mortality, morbidity, and hospitalization decision. Therefore, it is recommended to plan long-term randomized studies in more centers.
Objective: In this study' aim, to compare of NEWS and RTS in patients over 18 years of age who applied to the emergency department due to trauma the significance of the predictions of admission, discharge decision, survival and disability. Materials and Methods: This prospective and cross-sectional study included patients over the age of 18 who were admitted to Ege University Faculty of Medicine Emergency Department due to trauma between 11.06.2020-11.12.2020. The demographic data of the patients, admission trauma mechanisms, vital signs, NEWS and RTS values, clinical outcomes, mortality findings were collected with a case report form. Results: 404 patients were included in the study. Most of the patients were male (n = 284), and the most common trauma mechanism in the study (n = 159) was falling. Hypertension was determined as the most common comorbidity (n = 64). Patients were mostly (n = 289) discharged. It was found that both scoring systems scored in the critical value range and had similar sensitivity and specificity in predicting morbidity, other clinic admissions and hospital admissions. NEWS was found to be an assessment tool with significant findings in terms of clinical significance compared to RTS in predicting 24th hour and 7th day mortality. Conclusion: The rapid and accurate management of the trauma patient in the emergency services is a health problem that affects morbidity and mortality. Trauma Scoring systems are very important in this respect. The scarcity of studies comparing both evaluation scores in literacy, limits the evaluations made in predicting mortality, morbidity, and hospitalization decision. Therefore, it is recommended to plan long-term randomized studies in more centers.
Açıklama
Anahtar Kelimeler
Acil Servis, Travma, NEWS, RTS, Emergency Service, Trauma, NEWS, RTS
