Abstract
Purpose: We aimed to retrospectively analyze the demographic, epidemiological and clinical features of forensic cases admitted to the pediatric emergency department and compare them with the literature.
Research Tools and Method: A total of 2355 patients, aged 0-18 years, admitted to the pediatric emergency department, defined as forensic cases, were included. Clinical and demographic data were obtained from patient files through retrospective evaluation.
Findings: Of 2355 cases, 49.2% were female and 50.8% were male. It was observed that the most frequent admission time interval was between 18:00 and 24:00. Of the cases, 2124 (90.2%) were poisoned, 114 (4.9%) foreign body ingestion, 57 (2.4%) electric shock, 41 (1.7%) substance ingestion, 19 0.8% of them applied for alcohol consumption. Of the cases, 13% (306) were admitted to suicide, 84.7% (1994) to accident, and 2.3% (55) to substance abuse. 82.6% of the cases who applied for suicide were female. The cases who applied due to poisoning were most frequently between 25-60 months. 57.9% of intoxications due to corrosive substance ingestion were boys and 42.1% were girls. Cases with foreign body ingestion were most common between 25-60 months, and 50.9% of the cases were found to be coins.
Conclusion: As the most common cases of poisoning were observed in our study, it was thought that the frequency of forensic cases in children could be reduced by keeping the drugs and corrosive substances kept at home in locked places out of the reach of children, and by increasing domestic security measures.
Keywords
References
- Akça H., Oğlakçıoğlu A., Güneri K. Evaluation of forensic cases admitted to pediatric emergency department: A single-center experience. Cerrahpaşa Med J 2019;43(3):75-9.
- Özdemir A., Elgörmüş Y., Çağ Y. Evaluation of the pediatric forensic cases admitted to emergency department. Int J Basic Clin Med 2016;4(1):1-8.
- Ökçesiz A., Kozacı N., Avcı M., Demirel B. The evaluation of pediatric forensic cases presented to emergency department. Emerg Med J 2018;3(3):75-81.
- Türkiye İstatistik Kurumu. data.tuik.gov.tr. [Çevrimiçi] [Alıntı Tarihi: 13 10 2021.] https://data.tuik.gov.tr/Bulten/Index?p=IstatistiklerleCocuk-2020-37228.
- CDC Injury Prevention and Control. CDC leading causes of death data visualization. [Çevrimiçi] [Alıntı Tarihi: 13 10 2021.] https://wisqars.cdc.gov/data/lcd/home.
- Yazar A., Akın F., Türe E., Odabaş D. Evaluation of forensic cases admitting to pediatric emergency clinic. Dicle Med J 2017;44(4):345-53.
- Kadıoğlu E. Pediatric forensic cases: An emergency department experience. J For Med 2018;32(1):1-9.
- Büken E., Yaşar ZF. Assesment of forensic children cases applying to the emergency service of Başkent University Ankara Hospital. The Bul Leg Med 2015;20(2):93-8.
- Esen FH., Doğan M. Forensic cases in pediatric emergency department: A single center experience. Pediatr Emerg Intensive Care Med 2021;9:7-10.
- Öztoprak Ü., Energin VM. Evaluation of patients admitted to the pediatric emergency department with intoxication. J Contemp Med 2020;10(4):585-90.
- Arsoy HE., Güneysu F. Examination of demographic and laboratory data of patients admitted to the pediatric emergency department with poisoning. Eurasian J Tox 2021;3(1):5-15.
- Baysal Ş., Yıldız F. Evaluation of epidemiological and demographic features of childhood poisoning cases. Aegean J Med Sci 2018;2:37-42.
- Ulusal Zehir Danışma Merkezi 2020 Yılı Raporu. Ankara.
- Bozlu G., Kuyucu N. Poisoning cases who admitted to the pediatrics emergency unit in the last five years: Evaluation of 1734 Cases. The Bul Leg Med 2018;23(2):106-9.
- Araz C., Toklucu MÖ., Nizamoğlu M., Pala E., İşcan H., Yazar AS., Özer R., İşlek İ. Evaluating the poisoning cases in Ümraniye Training and Research Hospital pediatric emergency department. Med J Bakırköy 2017;13:57-67.
- Kondolot M., Akyıldız B., Görözen F., Kurtoğlu S., Patıroğlu T. Evaluation of the poisoning cases who applied to the pediatrics emergency unit. Turkish Ped J 2009;52:68-74.
- Dündar İ., Akın Y., Yücel M., Yaykıran D. Evaluation of children and adolescent cases admitted to the pediatric emergency department for drug ıntoxication. J Pediatr Emerg Intensive Care Med 2020;8:140-5.
- Demirgan EB., Erol M., Demirgan S., Yiğit Ö., Türkay M. Retrospective evaluation of drug poisoning cases referring to pediatric emergency polyclinic. Okmeydanı Med J 2014;30(3):128-34.
- Tursun S., Alpcan A., Karahan İ. The retrospective analysis of carbon monoxide poisoning admissions to pediatric emergency room of a university hospital. KU Tıp Fak Derg 2020;22(1):199-207.
- Toklucu MÖ., Araz C., Nizamoğlu M., Pala E., Akova S., Karakayalı B. ve ark. A retrospective study of carbon monoxide poisoning cases in Ümraniye Educational and Research Hospital pediatric emergency department. ACU Sağlık Bil Derg 2016;3:123-8.
- Süzen A., Ertürk N., Karakuş SC., Güçlü MM. A retrospective study in southwest of Turkey: Minimally invasive approach in corrosive substance ingestion. Muğla Sıtkı Koçman Üniversitesi Tıp Derg 2021;8(2):80-3.
- Çıtlak HK. Retrospective evaluation of children who applied to emergency department for drinking a corrosive substance: ten-year experience. Tıpta Uzmanlık Tezi Malatya 2019. s.24-44.
- Altay D., Doğan Y. An unavoidable public health problem: Ingestion of corrosive substance in children. Fırat Med J 2018;23(1):28-31.
- Çelikkaya ME., Atıcı A., El Ç., Akçora B. A common public health problem: corrosive ingestion in children. İzmir Dr. Behçet Uz Çocuk Hast Derg 2018;8(3):184-8.
- Güler MA., İşlek A., Gür ST. Evaluation of children with a history of foreign body ingestion or suspection: A single center experience. Akdeniz Med J 2019;7(2):244-50.
- Kafadar H., Kafadar S. Evaluation of gastrointestinal foreign body cases. AU Sağlık Bil Derg 2019;5(2):1620-7.
- Erginel B., Karlı G., Gün-Soysal F., Keskin E., Özbey H., Çelik A., Salman T. Foreign body ingestion in pediatric patients. J Ist Faculty Med 2016;79(1):27-31.
- Berksoy EA., Yazıcı S. Clinical, demographic characteristics and factors affecting the clinical outcome of children with electrical injury: A single-center pediatric emergency clinic experience. The Bul Leg Med 2019;24(1):30-5.
- Oğuz S., Tuygun N., Akça H., Polat E., Karacan CD. Factors influencing clinical outcomes in children admitted to the emergency department with electrical injuries. J Pediatr Emerg Intens Care Med 2015;2:121-6.
Abstract
Amaç: Bu çalışmada çocuk acil servise başvuran adli nitelikteki olguların demografik, epidemiyolojik özelliklerini ve klinik özelliklerini retrospektif olarak incelemeyi ve literatür ile karşılaştırmayı amaçlandı.
Gereç ve Yöntem: Çalışmaya 01.01.2015-31.12.2020 tarihleri arasında çocuk acil polikliniğine başvuran, 0-18 yaş arası, adli olgu olarak nitelendirilen 2355 hasta dahil edildi. Klinik ve demografik verilerine retrospektif değerlendirmeyle hasta dosyalarından ulaşıldı.
Bulgular: 2355 olgunun %49,2’si kız, %50,8’si erkek idi. Ortalama başvuru yaşı 61,88 ± 57,8 ay idi. En sık başvuru saat aralığının 18:00 – 24:00 olduğu görüldü. Olguların 2124’ü (%90,2) zehirlenme, 114’ü (%4,9) yabancı cisim yutma, 57’si (%2,4) elektrik çarpması, 41’i (%1,7) madde alımı, 19’u (%0,8) alkol alımı nedeniyle başvurmuştu. Olguların %84,7’si (1994) kaza, %13’ü (306) intihar ve %2,3’ü (55) madde kötüye kullanım nedenli başvuruydu. Zehirlenme nedeni ile başvuran olgular en sık 25-60 ay arasındaydı. Zehirlenme nedeni ile başvuran olguların %93,9’u (1994) oral yolla, %6,1’i (130) inhalasyon yolu ile etkene maruz kalmıştı. Karbonmonoksit zehirlenmesi nedeniyle başvurular en sık 00:00- 06:00 saat aralığında ve kış mevsimindeydi. Korozif madde alımına bağlı zehirlenmelerin %57,9’u erkek, %42,1’i kız olup en çok 5 yaşın altında, başvuruların ise en sık 18.00-24.00 saat aralığında olduğu görüldü. İntihar nedeniyle başvuran olguların %82,6’sı kız cinsiyetteydi. Elektrik çarpması ve madde alımı nedenli olgularda ise erkek cinsiyet yüksek saptandı. Yabancı cisim yutma nedenli olgular en sık 25-60 ay arası olup, olguların %50,9’unda yutulan maddenin madeni para olduğu tespit edildi.
Sonuç: Çalışmamızda en sık zehirlenme nedenli olguların gözlenmiş olması sonucunda özellikle evde bulundurulan ilaçların ve korozif etkili maddelerin çocukların erişemeyeceği, kilitli yerlerde muhafaza edilmesi, ev içi güvenlik tedbirlerinin arttırılması ile çocuklardaki adli vaka sıklığının azaltılabileceği düşünüldü.
References
- Akça H., Oğlakçıoğlu A., Güneri K. Evaluation of forensic cases admitted to pediatric emergency department: A single-center experience. Cerrahpaşa Med J 2019;43(3):75-9.
- Özdemir A., Elgörmüş Y., Çağ Y. Evaluation of the pediatric forensic cases admitted to emergency department. Int J Basic Clin Med 2016;4(1):1-8.
- Ökçesiz A., Kozacı N., Avcı M., Demirel B. The evaluation of pediatric forensic cases presented to emergency department. Emerg Med J 2018;3(3):75-81.
- Türkiye İstatistik Kurumu. data.tuik.gov.tr. [Çevrimiçi] [Alıntı Tarihi: 13 10 2021.] https://data.tuik.gov.tr/Bulten/Index?p=IstatistiklerleCocuk-2020-37228.
- CDC Injury Prevention and Control. CDC leading causes of death data visualization. [Çevrimiçi] [Alıntı Tarihi: 13 10 2021.] https://wisqars.cdc.gov/data/lcd/home.
- Yazar A., Akın F., Türe E., Odabaş D. Evaluation of forensic cases admitting to pediatric emergency clinic. Dicle Med J 2017;44(4):345-53.
- Kadıoğlu E. Pediatric forensic cases: An emergency department experience. J For Med 2018;32(1):1-9.
- Büken E., Yaşar ZF. Assesment of forensic children cases applying to the emergency service of Başkent University Ankara Hospital. The Bul Leg Med 2015;20(2):93-8.
- Esen FH., Doğan M. Forensic cases in pediatric emergency department: A single center experience. Pediatr Emerg Intensive Care Med 2021;9:7-10.
- Öztoprak Ü., Energin VM. Evaluation of patients admitted to the pediatric emergency department with intoxication. J Contemp Med 2020;10(4):585-90.
- Arsoy HE., Güneysu F. Examination of demographic and laboratory data of patients admitted to the pediatric emergency department with poisoning. Eurasian J Tox 2021;3(1):5-15.
- Baysal Ş., Yıldız F. Evaluation of epidemiological and demographic features of childhood poisoning cases. Aegean J Med Sci 2018;2:37-42.
- Ulusal Zehir Danışma Merkezi 2020 Yılı Raporu. Ankara.
- Bozlu G., Kuyucu N. Poisoning cases who admitted to the pediatrics emergency unit in the last five years: Evaluation of 1734 Cases. The Bul Leg Med 2018;23(2):106-9.
- Araz C., Toklucu MÖ., Nizamoğlu M., Pala E., İşcan H., Yazar AS., Özer R., İşlek İ. Evaluating the poisoning cases in Ümraniye Training and Research Hospital pediatric emergency department. Med J Bakırköy 2017;13:57-67.
- Kondolot M., Akyıldız B., Görözen F., Kurtoğlu S., Patıroğlu T. Evaluation of the poisoning cases who applied to the pediatrics emergency unit. Turkish Ped J 2009;52:68-74.
- Dündar İ., Akın Y., Yücel M., Yaykıran D. Evaluation of children and adolescent cases admitted to the pediatric emergency department for drug ıntoxication. J Pediatr Emerg Intensive Care Med 2020;8:140-5.
- Demirgan EB., Erol M., Demirgan S., Yiğit Ö., Türkay M. Retrospective evaluation of drug poisoning cases referring to pediatric emergency polyclinic. Okmeydanı Med J 2014;30(3):128-34.
- Tursun S., Alpcan A., Karahan İ. The retrospective analysis of carbon monoxide poisoning admissions to pediatric emergency room of a university hospital. KU Tıp Fak Derg 2020;22(1):199-207.
- Toklucu MÖ., Araz C., Nizamoğlu M., Pala E., Akova S., Karakayalı B. ve ark. A retrospective study of carbon monoxide poisoning cases in Ümraniye Educational and Research Hospital pediatric emergency department. ACU Sağlık Bil Derg 2016;3:123-8.
- Süzen A., Ertürk N., Karakuş SC., Güçlü MM. A retrospective study in southwest of Turkey: Minimally invasive approach in corrosive substance ingestion. Muğla Sıtkı Koçman Üniversitesi Tıp Derg 2021;8(2):80-3.
- Çıtlak HK. Retrospective evaluation of children who applied to emergency department for drinking a corrosive substance: ten-year experience. Tıpta Uzmanlık Tezi Malatya 2019. s.24-44.
- Altay D., Doğan Y. An unavoidable public health problem: Ingestion of corrosive substance in children. Fırat Med J 2018;23(1):28-31.
- Çelikkaya ME., Atıcı A., El Ç., Akçora B. A common public health problem: corrosive ingestion in children. İzmir Dr. Behçet Uz Çocuk Hast Derg 2018;8(3):184-8.
- Güler MA., İşlek A., Gür ST. Evaluation of children with a history of foreign body ingestion or suspection: A single center experience. Akdeniz Med J 2019;7(2):244-50.
- Kafadar H., Kafadar S. Evaluation of gastrointestinal foreign body cases. AU Sağlık Bil Derg 2019;5(2):1620-7.
- Erginel B., Karlı G., Gün-Soysal F., Keskin E., Özbey H., Çelik A., Salman T. Foreign body ingestion in pediatric patients. J Ist Faculty Med 2016;79(1):27-31.
- Berksoy EA., Yazıcı S. Clinical, demographic characteristics and factors affecting the clinical outcome of children with electrical injury: A single-center pediatric emergency clinic experience. The Bul Leg Med 2019;24(1):30-5.
- Oğuz S., Tuygun N., Akça H., Polat E., Karacan CD. Factors influencing clinical outcomes in children admitted to the emergency department with electrical injuries. J Pediatr Emerg Intens Care Med 2015;2:121-6.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Forensic Medicine |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 1, 2023 |
| Submission Date | December 6, 2022 |
| Published in Issue | Year 2023 Volume: 37 Issue: 1 |
