A Retrospective Study to Compare the Glasgow Coma Score, Pediatric Trauma Score, and Injury Severity Score and Outcomes in 118 Pediatric Trauma Patients at a Single Emergency Center in Turkey.

BACKGROUND The main causes of accidental trauma in children include road traffic accidents (RTAs) and falling from height (FFH). Rapid and accurate assessment of severity of injury is required to guide effective management. This retrospective study aimed to compare the Glasgow Coma Score (GCS), Pediatric Trauma Score (PTS), and Injury Severity Score (ISS) and outcomes for 118 pediatric trauma patients at a single Emergency Department (ED) in Turkey. MATERIAL AND METHODS Patients admitted to Ankara City Hospital due to high-energy trauma between November 1, 2019 and April 30, 2020 were analyzed retrospectively. Data for 118 patients with trauma by major mechanisms, aged 0-17, were collected. Demographic characteristics, trauma-related characteristics, outcomes, and GCS, PTS, and ISS values were compared. It was examined whether there was a relationship between trauma severity and prognosis. In this context, trauma severity was defined by these scores. RESULTS Of the 118 admitted patients, 66 (55.9%) were discharged from the ED, 33 (28%) were transferred to the intensive care unit (ICU), and 19 (16.1%) were admitted to non-ICU departments in the hospital. With hospitalization, patients with thoracic trauma (P<0.001; OR 11.1; 95% CI 3.0-40) and patients with abdominal trauma (P=0.003; OR 4.0; 95% CI 1.5-10.8) were discharged significantly less frequently than patients with other types of trauma. Patients with low ISS (P<0.001) and high PTS (P<0.001) were discharged more often. The relationship between diagnosis and hospitalization was significant (P<0.001). CONCLUSIONS RTA and FFH are the leading trauma mechanisms in children. Boys experience more trauma. ISS and PTS provide accurate predictions of severe and poor prognosis in pediatric trauma cases.

Patterns and Outcomes of Traumatic Suicides: A Retrospective Study of 132 Patients Admitted to a Turkish Medical Center.

BACKGROUND Patients who have attempted suicide by traumatic mechanisms and who present to the Emergency Department (ED) are important due to their severity and high mortality. This retrospective study aimed to evaluate the presentation 132 cases of attempted suicide admitted to a hospital ED in Ankara, Turkey, between September 2022 and August 2023. MATERIAL AND METHODS This retrospective study assessed data on 132 adult patients who presented at the ED of Ankara City Hospital due to attempted suicide by traumatic method during a 1-year study period. The descriptive characteristics of the cases, their chronic psychiatric diseases, and the characteristics of their injuries were analyzed based on the duration of stay in the ED and hospital as outcome measures. RESULTS Among our study population, 67% were men and 33% were women, and 52% had a previous psychiatric diagnosis. Incision was the predominant trauma mechanism (n=102, 77.3%). Patients with upper-extremity injuries had shorter stays in the ED (P=0.013), while those injured in with motor vehicle-related injuries and those falling from height stayed in the hospital longer (P=0.018). CONCLUSIONS In the traumatic suicides discussed, upper-extremity injuries with incision predominated. Upper-extremity injuries had shorter ED treatment times. Those injured by falling from heights or by motor vehicles required longer clinical care in the hospital.

Helicopter Ambulance Transport to the Emergency Department: Demographic and Clinical Factors Impacting Outcomes in a Turkish Medical Center.

BACKGROUND Helicopter ambulances (HAs) are a significant component of pre-hospital emergency medical services. This study presents a report on the demographic and clinical factors associated with transport to the emergency department (ED) by HA of 161 patients to a single center in Turkey. MATERIAL AND METHODS Demographic data, diagnoses in arriving center's ED, transferred distance, and outcomes of 161 patients transferred by HAs between March 01, 2019 and May 31, 2021 were retrospectively evaluated. Mortality rates of the cases were compared both with age and according to the distance traveled within the diagnostic groups. RESULTS There were 134 patients (83.2%) with internal diseases, and cardiovascular diseases were the leading cause (68 patients, 41.6%); 27 patients (16.7%) were transferred due to trauma. The mean distance traveled with HAs was 167.1 km (range, 47.0-1316.0) and the median transfer time was 50 min. The most common form of hospitalization after ED arrival was intensive care hospitalization (n=78, 48.4%). Mortality increased as the transfer distance increased in elderly patients, as well as those with a cardiac or trauma-related diagnosis (P=0.015, P=0.044, P=0.028, respectively). CONCLUSIONS Most patients transferred by HA had severe disease. ED physicians dealing with patient transfer by HAs should be prepared for severe cases, both in the HA and in the ED. HAs may be preferred when making the transfer decision for elderly patients, trauma patients, and those with cardiac disease.