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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
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.
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.
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