2020-2023 yılları arasında N.E.Ü. Tıp fakültesi adli Tıp polikliniği'ne adli rapor tanzimi için başvuran göğüs bölgesi travmalı olguların adli tıp açısından retrospektif olarak incelenmesi
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Tarih
2024
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Göğüs bölgesi yaralanmaları, basit yumuşak doku travması gibi hafif bir yaralanmadan, yaşamı tehlikeye sokan bir duruma, ölüme neden olabilen yaralanmalara kadar geniş bir klinik tablo ile karşımıza çıkabilmektedir. Göğüs bölgesi yaralanmaları ülkemizde sıklıkla trafik kazası, ateşli silah yaralanması, kesici delici alet yaralanmaları, darp cebir yaralanmaları gibi etiyolojik nedenlerle oluşmakta ve adli olgu olarak değerlendirilmektedir. Adli olgular, hem hukuk davalarının hem de ceza davalarının konusu olabilmektedir. Hekimlerin adli olgulardaki görevi, hukuk birimlerinin taleplerine cevap olarak, adli olgunun yaralanmasının hukuki açıdan ağırlık düzeyini tespit etmektir. Çalışmamızda göğüs bölgesi yaralanmalı olguların sosyodemografik özellikleri, adli olay türü dağılımı, yaralanmanın adli tıp açısından ağırlık derecesinin belirlenmesi gibi kriterlerin incelenmesi, sonuçların literatürdeki benzer çalışmalarla karşılaştırılması amaçlanmıştır.
Yöntem: Necmettin Erbakan Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı’na 01.01.2020-01.01.2023 tarihleri arasında adli rapor düzenlenmesi için başvurun göğüs bölgesi yaralanmalı olgular retrospektif olarak incelenmiştir. İnceleme sonucu elde edilen veriler SPSS (Statistical Package for Social Sciences) 21.0 paket programı ile analiz edilmiştir.
Bulgular: Çalışmamız 296 olguyu kapsamaktadır. Olguların yaş ortalaması 37,99±18,73 bulunmuştur. Cinsiyet dağılımı %26,4 (n=78) kadın ve %73,6 (n=218) erkektir. Olgular en fazla %37,2 (n=110) yaz mevsiminde ve %14,5 (n=43) Temmuz ayında meydana gelmiştir. Taksirle yaralama oranı %58,1 (n=172), kasten yaralama oranı %41,9 (n=124)’dur. Tüm olgularda yaşamı tehlikeye sokan bir duruma neden olma oranı %37,8 (n=112) bulunmuştur. Etiyolojik neden olarak en sık %27,0 (n=80) ile araç içi trafik kazaları olduğu tespit edilmiştir. Tüm olguların %39,2 (n=116)’sinin basit bir tıbbi müdahale ile giderilebilecek
ölçüde hafif olduğu, %60,8 (n=180)’inin basit bir tıbbi müdahale ile giderilebilecek ölçüde hafif olmadığı belirlenmiştir. Olguların %69,3 (n=205)’ünde duyularından veya organlarından birinin işlevinin sürekli zayıflamasına/yitirilmesine neden olmadığı, % 7,8 (n=23) olguda duyularından veya organlarından birinin işlevinin sürekli zayıflamasına neden olduğu, %0,7 (n=2) olguda da duyularından veya organlarından birinin işlevinin yitirilmesine neden olduğu saptanmıştır. Olguların % 57,4 (n=170)’ünde kırık olmadığı, %12,2 (n=36)’sinde Türk Ceza Kanunu’nda Tanımlanan Yaralama Suçlarının Adli Tıp Açısından Değerlendirilmesi Rehberi’ne göre kemik kırığı puanı 4 olduğu görülmüştür. Kemik kırığı varlığı durumunda, %30,7 (n=91) ile en fazla kot bölgesinde olduğu görülmüştür.
Sonuç: Necmettin Erbakan Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı’na başvuran göğüs bölgesi travmalı olgular araç içi trafik kazası sebebiyle ve yaz aylarında sık meydana gelmiştir. Taksirle yaralama oranı kasten yaralama oranından yüksektir. Yaşamı tehlikeye sokan bir duruma neden olma oranı %37,8, basit bir tıbbi müdahale ile giderilebilecek ölçüde hafif olmama oranı %60,8, duyularından veya organlarından birinin işlevinin sürekli zayıflamasına neden olma oranı % 7,8, duyularından veya organlarından birinin işlevinin yitirilmesine neden olma oranı %0,7’dir. Toraks bölgesi, anatomik olarak akciğerler, solunum yolları, kalp ve ana damarlar gibi hayati yapı ve organları içermektedir. Bu sebeple toraks travmaları önemli bir mortalite ve morbidite sebebidir. Öte yandan toraks travmalı olguların hem ceza davalarının hem de hukuk davalarına konusu olabilmeleri sebebiyle, acil servislerde ve adli birimlerde yapılan muayenelerinde daha özenli ve dikkatli davranılması gerektiği düşünülmüştür.
Objective: Chest injuries can present a wide clinical spectrum, ranging from minor soft tissue trauma to life-threatening conditions that may result in death. Chest injuries in our country are frequently caused by etiological factors such as traffic accidents, firearm injuries, penetrating and cutting instrument injuries, and blunt force trauma, and are evaluated as forensic cases. Forensic cases can be the subject of both civil and criminal proceedings. The role of physicians in forensic cases is to determine the legal severity of the injury in response to requests from legal authorities. Our study aims to examine the sociodemographic characteristics of cases with chest injuries, the distribution of types of forensic incidents, and the determination of the severity of injuries from a forensic medicine perspective, as well as to compare the results with similar studies in the literature. Method: Cases with chest injuries that were referred to Necmettin Erbakan University Faculty of Medicine, Department of Forensic Medicine for the issuance of forensic reports between January 1, 2020, and January 1, 2023, were retrospectively analyzed. The data obtained from the analysis were analyzed using the SPSS (Statistical Package for Social Sciences) version 21.0 software. Results: Our study includes 296 cases. The mean age of the cases was found to be 37.99±18.73. Gender distribution was 26.4% (n=78) female and 73.6% (n=218) male. The majority of cases occurred in summer (37.2%) (n=110) and in July (14.5%) (n=43). The rate of injury by negligence was 58.1% (n=172), and the rate of injury by intention was 41.9% (n=124). In all cases, the rate of causing a life-threatening situation was found to be 37.8% (n=112). The most common etiological cause was found to be vehicle traffic accidents with a rate of 27.0% (n=80). It was determined that 39.2% (n=116) of all cases were mild enough to be resolved with a simple medical intervention, while 60.8% (n=180) were not mild enough to be resolved with a simple medical intervention. It was found that in 69.3% (n=205) of the cases, it did not cause permanent weakening or loss of function of one of the senses or organs, in 7.8% (n=23) of the cases, it caused permanent weakening of function of one of the senses or organs, and in 0.7% (n=2) of the cases, it caused loss of function of one of the senses or organs. It was observed that 57.4% (n=170) of the cases had no fractures, and 12.2% (n=36) had a bone fracture score of 4 according to the Guide for the Forensic Medicine Evaluation of Injury Crimes Defined in the Turkish Penal Code. In case of bone fracture, rib fracture was the most common with 30.7% (n=91). Conclusion: Cases with chest trauma that were admitted to the Department of Forensic Medicine, Faculty of Medicine, Necmettin Erbakan University, occurred frequently due to in-vehicle traffic accidents and during the summer months. The rate of injury by negligence is higher than the rate of injury by intention. The rate of causing a life-threatening situation is 37.8%, the rate of not being mild enough to be resolved with simple medical intervention is 60.8%, the rate of causing permanent weakening of one of the senses or organs' functions is 7.8%, and the rate of causing loss of one of the senses or organs' functions is 0.7%. Anatomically, the thorax contains vital structures and organs such as the lungs, respiratory tract, heart and main vessels. For this reason, thoracic traumas are an important cause of mortality and morbidity. On the other hand, since cases with thoracic trauma can be the subject of both criminal and civil cases, it is thought that more care and attention should be paid during examinations in emergency services and forensic units.
Objective: Chest injuries can present a wide clinical spectrum, ranging from minor soft tissue trauma to life-threatening conditions that may result in death. Chest injuries in our country are frequently caused by etiological factors such as traffic accidents, firearm injuries, penetrating and cutting instrument injuries, and blunt force trauma, and are evaluated as forensic cases. Forensic cases can be the subject of both civil and criminal proceedings. The role of physicians in forensic cases is to determine the legal severity of the injury in response to requests from legal authorities. Our study aims to examine the sociodemographic characteristics of cases with chest injuries, the distribution of types of forensic incidents, and the determination of the severity of injuries from a forensic medicine perspective, as well as to compare the results with similar studies in the literature. Method: Cases with chest injuries that were referred to Necmettin Erbakan University Faculty of Medicine, Department of Forensic Medicine for the issuance of forensic reports between January 1, 2020, and January 1, 2023, were retrospectively analyzed. The data obtained from the analysis were analyzed using the SPSS (Statistical Package for Social Sciences) version 21.0 software. Results: Our study includes 296 cases. The mean age of the cases was found to be 37.99±18.73. Gender distribution was 26.4% (n=78) female and 73.6% (n=218) male. The majority of cases occurred in summer (37.2%) (n=110) and in July (14.5%) (n=43). The rate of injury by negligence was 58.1% (n=172), and the rate of injury by intention was 41.9% (n=124). In all cases, the rate of causing a life-threatening situation was found to be 37.8% (n=112). The most common etiological cause was found to be vehicle traffic accidents with a rate of 27.0% (n=80). It was determined that 39.2% (n=116) of all cases were mild enough to be resolved with a simple medical intervention, while 60.8% (n=180) were not mild enough to be resolved with a simple medical intervention. It was found that in 69.3% (n=205) of the cases, it did not cause permanent weakening or loss of function of one of the senses or organs, in 7.8% (n=23) of the cases, it caused permanent weakening of function of one of the senses or organs, and in 0.7% (n=2) of the cases, it caused loss of function of one of the senses or organs. It was observed that 57.4% (n=170) of the cases had no fractures, and 12.2% (n=36) had a bone fracture score of 4 according to the Guide for the Forensic Medicine Evaluation of Injury Crimes Defined in the Turkish Penal Code. In case of bone fracture, rib fracture was the most common with 30.7% (n=91). Conclusion: Cases with chest trauma that were admitted to the Department of Forensic Medicine, Faculty of Medicine, Necmettin Erbakan University, occurred frequently due to in-vehicle traffic accidents and during the summer months. The rate of injury by negligence is higher than the rate of injury by intention. The rate of causing a life-threatening situation is 37.8%, the rate of not being mild enough to be resolved with simple medical intervention is 60.8%, the rate of causing permanent weakening of one of the senses or organs' functions is 7.8%, and the rate of causing loss of one of the senses or organs' functions is 0.7%. Anatomically, the thorax contains vital structures and organs such as the lungs, respiratory tract, heart and main vessels. For this reason, thoracic traumas are an important cause of mortality and morbidity. On the other hand, since cases with thoracic trauma can be the subject of both criminal and civil cases, it is thought that more care and attention should be paid during examinations in emergency services and forensic units.
Açıklama
Anahtar Kelimeler
Göğüs Travması, Chest Trauma, Adli Olgu, Forensic Case, Adli Tıp, Forensic Medicine
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kök, Y. (2024). 2020-2023 yılları arasında N.E.Ü. Tıp fakültesi adli Tıp polikliniği'ne adli rapor tanzimi için başvuran göğüs bölgesi travmalı olguların adli tıp açısından retrospektif olarak incelenmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Adli Tıp Anabilim Dalı, Konya.
