Acil Serviste Çocuklarda Düşme Olgularının Yönetimi: 261 Çocuk Olgunun Analizi

Abstract

Objective: Pediatric falls cause a significant burden for emergency departments and have negative patient outcomes such as prolonged length of stay and increased costs. The objective of this study was to evaluate results of the management of pediatric fall cases in an emergency department.Material and Methods: Pediatric patients who presented to our emergency department due to falling injury were evaluated and analyzed according to the demographic data, including age and gender, Glasgow Coma Scale, Injury Severity Score time of presentation, site of injury, diagnosis, department of consultation, department of hospitalization, length of stay and cost. After the initial management in the emergency department, patients were consulted and referred to other departments, if deemed necessary.Results: A total of 261 children were included in the study. Hospital admissions were most frequently made in summer, in August and on Saturdays. The children were most diagnosed by fractures followed by soft tissue trauma. The most injured body part was the head-neck region followed by extremities. The most frequently consulted departments included neurosurgery and orthopedics and traumatology. A total of 101 (38.7%) children were hospitalized. The median Injury Severity Score value of the patients was found as 3 and the median Glasgow Coma Scale value was found as 15 (8-15). The median treatment cost was found to be ₺278.8. The median length of stay was found as 31 (interquartile range, 21-63.5) (interquartile range için 2 sayısal değer verilmeli) hours. A strong positive correlation was found between length of stay and costs (r=0.629, p<0.001). Conclusion:Pediatric age group fall injuries are common events that increase the workload of the emergency department and create a significant burden and cost for the health system and society. Our results show that, as expected, there is a very strong relationship between length of stay and treatment costs.Amaç: Çocuklarda düşme, acil servisler üzerinde önemli bir yük oluşturmakta ve hastanede kalış süresinde uzama ile artan maliyetler gibi olumsuz sonuçlara neden olabilmektedir. Bu çalışmanın amacı, bir acil serviste çocuklarda düşme olgularının yönetim sonuçlarının değerlendirilmesidir. Gereç ve Yöntemler: Düşme kaynaklı yaralanma nedeniyle acil servisimize başvuran pediatrik hastalar; yaş ve cinsiyet gibi demografik veriler, Glasgow Koma Skalası, Injury Severity Score skorları, başvuru zamanları, yaralanma bölgesi, tanı, konsülte edilen bölüm, yatış verilen bölüm, hastanede kalış süresi ve maliyetler açısından değerlendirilmiş ve analiz edilmiştir. Acil servisteki ilk yönetim sonrasında gerekli görülen hastalar diğer bölümlerle konsülte edilerek sevk edilmiştir.Bulgular: Çalışmaya 261 çocuk dahil edildi. Başvurular en sık yaz mevsiminde, Ağustos ayında ve Cumartesi günleri yapılmıştır. Çocuklarda en sık konulan tanılar kırık ve yumuşak doku hasarıdır. En sık yaralanan vücut bölgeleri baş-boyun bölgesi ve ekstremitelerdir. En sık konsültasyon yapılan bölümler beyin ve sinir cerrahisi il...

Evaluation of intentional and unintentional injuries in children and adolescents with trauma scoring systems

“…The ISS values were seen to be considerably higher in cases of multiple trauma in child victims wounded as a consequence of a falling [18]. In this study, the ISS and NISS values were significantly higher in multiple traumas than in head and neck injury, extremity injury, and chest injury.…”

“…Children under the age of 16 years with a head or chest injury had a higher risk of death compared to children with other injuries [8]. Demirel and Akpınar reported that in children injured as a result of falling, the most common injuries were to the head and neck (49%) and extremities (39%) [18]. The extremities (45.10%) and head-neck area (34.80%) were the most prevalent injuries in children under the age of 15 years in traffic accidents, according to Serinken and Zen [16].…”