Karakus Ali, Kuvandik Guven, Atalay Ezgi
Mustafa Kemal University, Faculty of Medicine, Emergency Medicine, Hatay, Turkey.
Mustafa Kemal University, Hatay Health Services, Vocational School, First and Emergency Assistance Program, Hatay, Turkey.
Arch Iran Med. 2017 Oct;20(10):646-648.
In this study, we aimed to review cases with firearms injury of extremities presented to our hospital.
After approval by Institutional Board, electronic database was retrospectively screened for firearms injury of extremities between 2012 and 2015. Overall, 600 cases with firearms injury of extremities were included in the study. Cases were assessed for demographic and clinical characteristics, Mangled extremity severity score (MESS), Glasgow Coma Scale (GCS), costs and outcomes.
Totally, 552 (92.0%) cases were men and 48 (8.0%) were women. Mean age was 29.97 ± 10.40 years (range: 5-64 years). A significant difference was detected in gender distribution. Of the cases, 96.6% (n = 580) were Syrian war casualties. Lower extremity injury was the most frequently seen injury (n = 312; 52.0%). Mean MESS score was 4.71 ± 1.32 (range: 2-9). GCS score was <8 in 3 fatal cases (0.5%) whereas it was 15 in 597 cases (99.5%). It was found that 66 cases (11.0%) underwent amputation after they arrived in the hospital as a result of crush injury due to mine and blast. In cases who underwent amputation, a positive correlation was detected in MESS scores (P = 0.00). Mean cost was estimated to be 6,936 TL (280-32,232 TL).
Young male and lower extremity injuries were most commonly encountered. Amputation was performed in the early period in cases with highest MESS scores. It was seen that amputation was common in crush injuries due to mine and blast. It was found that patient volume at emergency department and hospital and costs were increased due to war.
在本研究中，我们旨在回顾我院收治的四肢火器伤病例。
经机构委员会批准后，对2012年至2015年间的四肢火器伤进行电子数据库回顾性筛查。本研究共纳入600例四肢火器伤病例。对病例的人口统计学和临床特征、肢体毁损严重程度评分（MESS）、格拉斯哥昏迷量表（GCS）、费用及结局进行评估。
共有552例（92.0%）为男性，48例（8.0%）为女性。平均年龄为29.97±10.40岁（范围：5 - 64岁）。性别分布存在显著差异。其中96.6%（n = 580）的病例为叙利亚战争伤员。下肢损伤是最常见的损伤类型（n = 312；52.0%）。平均MESS评分为4.71±1.32（范围：2 - 9）。3例死亡病例（0.5%）的GCS评分<8，而597例（99.5%）的GCS评分为15。发现66例（11.0%）因地雷和爆炸导致的挤压伤在入院后接受了截肢手术。在接受截肢手术的病例中，MESS评分存在正相关（P = 0.00）。平均费用估计为6936土耳其里拉（280 - 32232土耳其里拉）。
最常遇到的是年轻男性和下肢损伤。MESS评分最高的病例在早期进行了截肢手术。可见，地雷和爆炸导致的挤压伤中截肢很常见。发现由于战争，急诊科和医院接待的患者数量及费用有所增加。
