Karakuş Ali, Kekeç Zeynep, Akçan Ramazan, Seydaoğlu Gülşah
Department of Emergency Medicine, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey.
Ulus Travma Acil Cerrahi Derg. 2012 Jul;18(4):289-95. doi: 10.5505/tjtes.2012.81488.
In this study, we aimed to determine the effects of trauma severity on cardiac involvement through evaluating the trauma severity score together with diagnostic tests in multiple trauma patients. A trauma score was determined using various trauma severity scales.
After obtaining the approval of the ethics committee of the faculty, this prospective study was performed through evaluating 100 multiple trauma patients, aged over 15 years, who applied to our Emergency Department (ED). After determining the trauma severity score using instruments such as the Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Revised Trauma Score (RTS), the cardiac condition was evaluated using biochemical and radiological diagnostic tests.
During the study period, 100 patients were evaluated (78 male, 22 female; mean age: 33.2±15.4; range 15 to 70 years). It was determined that 92 (92%) were blunt trauma cases, and 77 (77%) of them were due to traffic accidents. The majority of cases showed electrocardiogram (ECG) abnormalities (63%) and sinus tachycardia (36%). Abnormal echocardiogram (ECHO) findings, mostly accompanied by ventricular defects (n=24), were determined in 31 of the cases. Nineteen cases with high trauma severity score resulted in death, and 14 of all deaths were secondary to traffic accidents. Trauma scores were found to show a significant difference between the two groups.
The ISS trauma scale was determined to be the most effective in terms of indicating heart involvement in patients with multiple traumas. Close follow-up and cardiac monitoring should be applied to patients with high trauma severity scores considering possible cardiac rhythm changes and hemodynamic disturbances due to cardiac involvement.
在本研究中，我们旨在通过评估多发伤患者的创伤严重程度评分以及诊断测试，来确定创伤严重程度对心脏受累的影响。使用各种创伤严重程度量表确定创伤评分。
在获得学院伦理委员会的批准后，通过评估100例年龄超过15岁、前来我院急诊科就诊的多发伤患者进行了这项前瞻性研究。使用损伤严重程度评分（ISS）、格拉斯哥昏迷量表（GCS）和修订创伤评分（RTS）等工具确定创伤严重程度评分后，使用生化和放射学诊断测试评估心脏状况。
在研究期间，共评估了100例患者（男性78例，女性22例；平均年龄：33.2±15.4岁；范围15至70岁）。确定92例（92%）为钝性创伤病例，其中77例（77%）是由交通事故导致。大多数病例表现为心电图（ECG）异常（63%）和窦性心动过速（36%）。在31例病例中确定了异常的超声心动图（ECHO）结果，大多数伴有心室缺损（n = 24）。19例创伤严重程度评分高的患者死亡，所有死亡病例中有14例继发于交通事故。发现两组之间的创伤评分存在显著差异。
在指示多发伤患者的心脏受累方面，ISS创伤量表被确定为最有效。考虑到心脏受累可能导致的心律变化和血流动力学紊乱，应对创伤严重程度评分高的患者进行密切随访和心脏监测。
