ORIJINAL ARAŞTIRMA
Sağlık Kuruluna Başvuran Erişkin Ampüte Hastaların Demografik ve Klinik Özelliklerinin İncelenmesi
Investigation of Demographic and Clinical Characteristics of Adult Amputee Patients Applying to the Health Board
Received Date : 13 Dec 2021
Accepted Date : 28 Feb 2022
Available Online : 07 Mar 2022
Fatma ÖZCAN
a, Ayşe Naz KALEM ÖZGENa, Yasin DEMİRa, Nazmiye Merve ÖRÜCÜ ATARa,
Gizem KILINÇ KAMACIa, Engin KOYUNCUa, Koray AYDEMİRa, Kenan TANa
aSağlık Bilimleri Üniversitesi Gaziler Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, Türkiye
Doi: 10.31609/jpmrs.2021-87513 - Makale Dili: TR
J PMR Sci. 2022;25(2):254-63
ÖZET
Amaç: Alt ve üst ekstremite ampütasyonu yapılan erişkin hastalardan,
ana referans hastanenin sağlık kuruluna başvuranların demografik ve
klinik verilerinin incelenmesi hedeflendi. Gereç ve Yöntemler: Gaziler
Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi sağlık kuruluna
1 Ağustos 2016-31 Ekim 2021 tarihleri arasında başvuran 195 erişkin
ampüte hastanın dosyaları retrospektif olarak tarandı. Hastaların demografik
bilgileri (cinsiyet, şimdiki yaş, olay zamanı yaş, beden kitle indeksi, statü,
meslek, medeni durum, eğitim düzeyi), klinik bilgileri (olay süresi, yaralanma
sebebi, etkilenmiş ekstremite durumu, ampütasyon seviyesi, güdük
uzunluğu, K aktivite düzeyi) ve raporda yazılan protez tipi kaydedildi.
Bulgular: Hastaların şimdiki yaş ortalaması 36,5±10,4 olup; olay zamanı
yaş ortalaması 26,4±6,6 idi. En sık yaralanmanın 21-30 yaş grubunda olduğu
(n=138, %70,7) ve en sık yaralanma sebebinin mayına basma olduğu
(n=93, %47,7) belirlendi. Üst ekstremitede en sık transradyal ampütasyon
saptanırken (n=9, %30); alt ekstremitede en sık transtibial ampütasyon olduğu
görüldü (n=53, %30,5). Üst ekstremite protezlerinde en sık miyoelektrik
kontrollü kol protezinin (n=17, %56,7), alt ekstremite protezlerinde ise
en sık modüler transtibial protezin (n=54, %31) reçete edildiği belirlendi.
Mayına basma ve el yapımı patlayıcı maruziyeti olan hastaların olay zamanı
yaş ortalaması, diğerlerine göre anlamlı derecede küçüktü (p=0,021). Diz
dezartikülasyonu ve üzeri seviyede ampütasyonu olan hastalarda, K aktivite
düzeyi istatistiksel olarak anlamlı derecede düşüktü (p<0,001). Transfemoral
ampütasyonu olan hastalarda ise güdük uzunluğu ile K aktivite
düzeyi arasında anlamlı korelasyon saptandı (p=0,028, r=0,294). Sonuç:
Ampütasyon oranını azaltmak için eğitim ile muhtemel yaralanma nedenleri
konusunda bilinçlilik artırılmalı ve genel güvenlik düzenlemeleri yapılmalıdır.
Anahtar Kelimeler: Ampütasyon; sağlık kurulu; protez; mayına basma; K aktivite düzeyi
ABSTRACT
Objective: It was aimed to examine the demographic and
clinical data of adult patients who had lower and upper extremity amputations,
who applied to the health board of the main reference hospital.
Material and Methods: The files of 195 adult amputee patients who were
admitted to the Gaziler Physical Therapy and Rehabilitation Training and
Research Hospital health board between August 1, 2016-October 31, 2021
were retrospectively reviewed. Demographic data of the patients (sex, current
age, age at the time of the injury, body mass index, status, occupation,
marital status, education level), clinical data (event duration, cause of injury,
affected extremity status, amputation level, stump length, K activity
level) and the type of prosthesis written in the report was recorded. Results:
The mean present age of the patients was 36.5±10.4 years and the mean age
at the time of the injury was 26.4±6.6 years. It was determined that the most
common injury was in the 21-30 age group (n=138, 70.7%) and the most common
cause of injury was landmine (n=93, 47.7%). While the most common
transradial amputation was found in the upper extremity (n=9, 30%), the most
common transtibial amputation was found in the lower extremity (n=53,
30.5%). It was determined that myoelectric controlled arm prosthesis was prescribed
most frequently in upper extremity prostheses (n=17, 56.7%) and modular
transtibial prosthesis was most frequently prescribed in lower extremity
prostheses (n=54, 31%). The mean age of the patients with landmine and handmade
explosive was significantly younger than the others (p=0.021). K activity
level was found to be statistically significantly lower in patients with knee
disarticulation and above level amputation (p<0.001). A significant correlation
was found between stump length and K activity level in patients with
transfemoral amputation (p=0.028, r=0.294). Conclusion: In order to reduce
the amputation rate, awareness of possible causes of injury should be increased
and general safety arrangements should be made.
Keywords: Amputation; health board; prosthesis; landmine; K activity level
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