Kartal Yeter Nil Deniz, Karaca Mehmet Ali, Yeter Ahmet Sefa, Öztürk İnce Elif, Erbil Bülent
Vocational School of Health Services, First and Emergency Aid Program, Hacettepe University, Ankara, Turkey.
Faculty of Medicine, Department of Emergency Medicine, Hacettepe University, Ankara, Turkey.
BMC Emerg Med. 2024 Sep 16;24(1):168. doi: 10.1186/s12873-024-01077-9.
Approximately 458,000 victims were deceased from intentional violence in 2021. A stabbing assault causes 25% of homicides. The study aims to evaluate injury patterns, trauma scores, radiological findings, types of treatment, and outcomes of stab assault patients admitted to a tertiary emergency department (ED).
This is a retrospective observational study of stabbing injury patients in the ED of Hacettepe University, Turkey. The sites and patterns of injury, radiological findings, treatment methods, consultations, and complications are acquired from the patient's files. Trauma scores and frequency of outcomes, such as the need for surgery, hospitalization, or mortality, were calculated for all patients.
Among the 648 patients, 564 (87%) were male. The median age was 28 (interquartile range [IQR]:13). The commonly injured body parts were the extremities (75%), thorax (21.9%), and abdomen (16.9%). The median RTS was 7,84 (IQR:0), and the median ISS was 2 (IQR:3). The fluid was detected in 13 of 88 patients by FAST, solid organ injuries in 21 patients, and gastric and intestinal injuries in 11 patients by abdominal CT. One hundred sixty-one patients underwent moderate and major surgery. Complications developed in 13 patients. 74,4% of the patients (n = 482) were treated in ED and 21.8% (n = 141) of patients were hospitalized in wards, 2.3% (n = 15) in intensive care unit and 1.5% (n = 10) patients died. GCS, RTS, and probability of survival (Ps) were significantly lower, and ISS was significantly higher in deceased patients and patients who needed erythrocyte replacement.
The majority of stab wounds were detected in extremities, but severe and lethal stabbing injuries were on the thorax and abdomen. In thoracoabdominal stabbing injuries, x-rays and FAST can be ineffective in detecting critical and fatal injuries. Therefore, thoracic and abdominal CT should be planned early to detect possible causes of death and make a timely and accurate diagnosis. Lower GCS, RTS, and Ps or higher ISS scores were related to the need for erythrocyte replacement.
2021年约有45.8万名受害者死于故意暴力。刺伤导致25%的凶杀案。本研究旨在评估三级急诊科收治的刺伤患者的损伤模式、创伤评分、影像学检查结果、治疗类型及预后。
这是一项对土耳其哈杰泰佩大学急诊科刺伤患者的回顾性观察研究。从患者病历中获取损伤部位和模式、影像学检查结果、治疗方法、会诊情况及并发症。计算所有患者的创伤评分及手术需求、住院情况或死亡率等预后频率。
648例患者中，564例（87%）为男性。中位年龄为28岁（四分位间距[IQR]：13）。常见受伤身体部位为四肢（75%）、胸部（21.9%）和腹部（16.9%）。中位RTS为7.84（IQR：0），中位ISS为2（IQR：3）。88例患者中13例通过FAST检测到有积液，21例通过腹部CT检测到实质器官损伤，11例检测到胃肠道损伤。161例患者接受了中大型手术。13例患者出现并发症。74.4%的患者（n = 482）在急诊科接受治疗，21.8%（n = 141）的患者住院，2.3%（n = 15）入住重症监护病房，1.5%（n = 10）的患者死亡。死亡患者和需要红细胞置换的患者的GCS、RTS和生存概率（Ps）显著更低，而ISS显著更高。
大多数刺伤发生在四肢，但严重和致命的刺伤发生在胸部和腹部。在胸腹刺伤中，X线和FAST可能无法有效检测到关键和致命损伤。因此，应尽早安排胸部和腹部CT检查，以发现可能的死亡原因并做出及时准确的诊断。较低的GCS、RTS和Ps评分或较高的ISS评分与红细胞置换需求相关。
