Ulus Travma Acil Cerrahi Derg. 2006; 12(2): 135-142

Epidemiological characteristics of electrical injuries of patients applied to the emergency department

Behçet Al¹, Mustafa Aldemir¹, Cahfer Güloðlu¹, Ýsmail Hamdi Kara², Sadullah Girgin^3
1Departments Of Emergency Medicine Faculty Of Dicle University, Diyarbakýr, Turkey
²Departments Of Family Medicine Faculty Of Dicle University, Diyarbakýr, Turkey
³Departments Of General Surgery, Medicine Faculty Of Dicle University, Diyarbakýr, Turkey

BACKGROUND: In this study, we planned to determine the factors affecting the mortality, and morbidity of electrical injuries.
METHODS: Medical records of 165 patients (126 males; 39 females; mean age 21.1 years; range 2.5 to 62 years), who were admitted to the Emergency Department of Dicle University School of Medicine for electrical injuries, between January 2003 and April 2004, were retrospectively reviewed.
RESULTS: Among these patients, 60 (36.4%) were children, under 12 years old; 95 (57.6%) were adolescents and adults, and 10 (6%) were aged. Of the victims of electrical accidents, 29 (17.6%) were illiterate and 36 (21.8 %) were educated. Ninety-seven (58.8 %) patients were either graduates or still students of elementary, secondary or high school. The cause of exposure to electricity was accident in 99 (60%), and carelessness and parents' negligence in 66 (40%). Sixty-nine (41.8%) patients were exposed to high voltage, and 96 (58.2 %) to low voltage. Because of electrical injury 16 patients had first degree, 96 patients had second degree, and 86 patients had third degree burns. The most frequent complications were contractures of extremities (10.9%) and compartment syndrome (3.6%). Mortality rate was 9.1% (n=15). Eighty percent of the deaths were due to exposure to high voltage. A positive correlation was demonstrated between mortality and complications (p<0.001). Escarotomy was performed in 10 patients, fasciotomy in 16, and amputation in 9. Two of 5 patients who had intraabdominal hemorrhage underwent surgery.
CONCLUSION: A serious education of the society with respect to conscious use of of electricity is the most efficient method to decrease electrical accidents.

Keywords: Burns, electric, burns/epidemiology, electric injuries/ mortality/physiopathology; electricity

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Elektrik çarpmasý sonucu acil servise baþvuran hastalarýn epidemiyolojik özellikleri

Behçet Al¹, Mustafa Aldemir¹, Cahfer Güloðlu¹, Ýsmail Hamdi Kara², Sadullah Girgin^3
1Dicle Üniversitesi Týp Fakültesi, Ýlk Ve Acil Yardým Anabilim Dalý, Diyarbakýr, Türkiye
²Dicle Üniversitesi Týp Fakültesi, Aile Hekimliði Anabilim Dalý, Diyarbakýr, Türkiye
³Dicle Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Diyarbakýr, Türkiye

AMAÇ: Bu çalýþma, elektrik çarpmalarýnýn epidemiyolojik özelliklerini belirlemek, mortalite ve morbiditeye etkili olan faktörleri saptamak için planlandý.
GEREÇ-YÖNTEM: Dicle Üniversitesi Týp Fakültesi Acil Kliniðine Ocak 2003-Nisan 2004 tarihleri arasýnda elektrik çarpmasý þikayetiyle baþvuran 165 hasta (126 erkek; 39 kadýn; ort. yaþ 21.1; daðýlým 2.5-62) yaþ, cinsiyet, elektik kaynaðý ve gücü, yanýk derecesi ve yüzdesi, oluþan komplikasyonlar, yapýlan müdahaleler, eðitim durumu ve meslekleri bakýmýndan deðerlendirildi.
BULGULAR: Hastalarýn, 60’ý (%36.4) 12 yaþýn altýnda, 95’i (%57.6) genç ve eriþkin yaþta ve 10’u (%6) ileri yaþta idi. Yirmi dokuz (%17.6) hasta okuryazar deðil, 36’sý (%21.8) okuryazar ve 97’si (%58,8) halen eðitim görmekte idi. Yanýklarýn 99’u (%60) kaza, 66’sý (%40) ise dikkatsizlik ve ihmal sonucu oluþmuþtu. Hastalarýn 69’u (%41.8) yüksek, 96’sý (%58.2) düþük voltaja maruz kalmýþtý. On altý hastada birinci derece, 96 hastada ikinci derece ve 86 hastada üçüncü derece yanýk meydana gelmiþti. En sýk görülen komplikasyonlar, ekstremitelerde kontraktür (%10.9) ve kompartman sendromu (%3.6) idi. Hastalarýn 10’una eskarotomi, 16’sýna fasyotomi, 9’una amputasyon uygulanmýþtý. Mortalite oraný %9.1 (n=15) idi ve bu olgularýn %80’i yüksek elektrik voltajýna maruz kalmýþtý. Gözlenen komplikasyonlar ile mortalite arasýnda pozitif bir korelasyon saptandý (p<0.001).
SONUÇ: Elektrik sistemlerinin doðru kullanýmý ile ilgili toplumsal eðitimin verilmesi, ev içi ve ev dýþý elektrik hatlarýnýn gizli döþenmesi gibi basit önlemlerin alýnmasý ile kazalar en aza indirilebilecektir.

Anahtar Kelimeler: Yanýklar, elektrik, yanýk/epidemiyoloji; elektrik yaralanmasý/mortalite/fizyopatoloji; elektrik

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