Nil Kartal | Hacettepe University (original) (raw)

Papers by Nil Kartal

Trauma is the major leading cause ofdeath in healthy young adults between the ages 1-44 . The mos... more Trauma is the major leading cause ofdeath in healthy young adults between the ages 1-44 . The most common factors that cause death aretraffic accidents, falls from height, gunshot wounds and penetrating or stab wounds.Penetratingtrauma by sharp object (knives, arrows) is classified in Low-velosity wounds and damage is related todepth and angle of attack. The importance of penetrating injuries varies according to the body partand findings of some penetrating injuries may be initially obscured.The present study evaluates thetrauma mechanisms, types of injury and demographic data of the penetrating trauma patientsadmitted to the Emergency Departments of Hacettepe University.Travmalar 1-44 yaşarasındaki sağlıklı genç erişkinlerdeki ölümlerin birinci sebebidir. Travmaya sebep olan en sıketkenler; trafik kazaları, yüksekten düşmeler, ateşli silah veya delici kesici alet yaralanmalarıdır.Penetran delici kesici alet yaralanmaları (bıçak,ok ,vs.) düşük hızlı yaralanma olarak sınıflanır vetah...

Turkish Journal of Trauma and Emergency Surgery, 2015

BACKGROUND: This study aimed to evaluate injury patterns of patients admitted to the emergency de... more BACKGROUND: This study aimed to evaluate injury patterns of patients admitted to the emergency department with gunshot wounds, results of imaging studies, treatment modalities, outcomes, mortality ratios, and complications. METHODS: A retrospective descriptive study was carried out including a total number of one hundred and forty-two patients admitted to Hacettepe University Emergency Department with gunshot injuries between January 1, 1999 and December 31, 2013. The Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Injury Severity Score (ISS), and theTrauma and Injury Severity Score (TRISS) probability of survival for penetrating trauma were calculated for all patients. RESULTS: Among the one hundred and forty-two patients in the study, one hundred and twenty-eight (90.1%) were male. Mean age was 36 years. On admission, the average GCS score was 13, mean RTS was 6.64, median ISS was 5 and median TRISS probability for survival was 99.4% for penetrating trauma. Fluid was detected in three (13%) patients in FAST, whereas intra-abdominal solid organ injury and bowel injury were detected in 11 (58%) patients in abdominal CT. The pneumothorax, hemothorax and lung injuries were detected in 10 (40%) patients, whereas hemothorax was detected only in one patient with thoracic injury by chest X-ray. Twenty four (16.9%) patients died; eighteen patients (75%) had isolated severe intracranial injuries, two (8.3%) had thoracic injuries with head and neck injuries, and four (16.7%) patients had intra-abdominal organ injuries (one with concomitant head injury). Ten patients were brought to the ED in cardiopulmonary arrest. In dead patients, GCS, RTS and TRISS were significantly lower, and ISS were significantly higher than in surviving patients. Twenty three (95.8%) patients were in critical injury level (ISS 25-75, actually ISS >50) in the exitus group. CONCLUSION: Mortality rates in gunshot wound patients with cranial injuries are very high. Spontaneous return is not seen in patients brought to the ED in arrest state. Bullets can cause internal organ injuries which can be greater than expected. In thoracoabdominal gunshot wound injuries, conventional X-ray and bedside FAST can be ineffective in detecting the whole extent of intrathoracic and intra-abdominal injuries. Thus, thoracic and abdominal CT should be planned early for hemodynamically stable patients in order to eliminate causes of fatality and make a timely and correct diagnosis. ISS, RTS and GCS are useful in predicting prognosis and mortality. Especially in patients with ISS scores >50, the mortality rate can be as high as 96%.

Turkish Journal of Trauma and Emergency Surgery, 2015