Analysis of 264 Patients with Stab and Gunshot Wounds in Abdominal and Thoracic Regions
Guven, Fatma Mutlu Kukul
Eren, Sevki Hakan
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Introduction: Penetrating traumas are life-threatening situations which can be encountered in emergency services. In this study, epidemiological data, treatment approaches and the results pertaining to penetrant abdominal and/or thoracic injuries, which occured due to gunshot or stab wounds, are evalauted retrospectively. Material-method: Two hundred and sixty four patients who admitted to emergency department with penetrating thoracic and/or abdominal trauma between 2002 and2009 were retrospectively analyzed. Patients were divided into 3 groups according to their shock indexes including Low risk (<= 0.5), medium risk (> 0.5-<= 1) and high risk (> 1) groups. Results: The study group included 244 male (92.4%) and 20(7.6%) female participants. Age distribution of the groups was as follows; 58 (22.0%) patients were in the 0-19 years group, 139 patients (52.6%) were in the 20-40 years group and 67 patients (25.4%) were over 40 years. Two hundred and fifteen injuries (81.4%) were caused by stab wounds and 49 (18.6%) were due to gunshots. When the patients were evaluated considering the injury site, isolated thoracic trauma was seen in 93 patients (35.3%) and isolated abdominal injuries were found in 74 patients (28.0%). The most common organ injuries among the patients who underwent laparotomy (n=73) were as follows; bowel injury in 28 patients (38.3%), stomach injuries in 20 patients (27.4%) and liver-spleen injuries in 17 patients (23.28 %). Of 189 patients with thoracic trauma, 17 patients (8.9 %) had hemothorax, 44 (23.28 %) had pneumothorax, 46 (24.33 %) had hemopneumothorax and 2 patients (1.05 %) had pulmonary contusion. Seven patients (2.65 %) died. Two patients were considered as exitus in the initial examination. Two of the 5 exitus cases had shock index ranging within the medium risk group and 3 were in the high-risk group. Conclusion: It must be considered that penetrating trauma patients with medium or high shock index have a higher mortality rate. Therefore, those patients must be closely monitored and the health services should be improved for immediately and appropriately transferring them.