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Bezmialem Vakıf Üniversitesi Hastanesi Acil Servisine Başvuran Adli Nitelikli Olguların ve Adli Raporların Değerlendirilmesi

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2021-12-12T00:00:00Z
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Kara, Kerem
Taşlıdere, Bahadır
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Abstract
Evaluation of Forensic Cases and Forensic Reports Appealing to Bezmialem Vakıf University Emergency DepartmentIntroductionForensic cases are all events caused by intent, negligence, recklessness or carelessness that cause a person to be physically or mentally victimized (1, 2). Firearm injuries, stab injuries, traffic accidents, falls, beatings, work accidents, poisonings, burns, electric shocks, sexual assaults, all kinds of suicide attempts, torture allegations, suspicious or unexpected deaths can be considered as forensic cases. The first place where these cases are evaluated is usually the emergency departments. Therefore, physicians working in emergency departments have a great responsibility (3, 4). We retrospectively evaluated the forensic reports written in the emergency department of our hospital with this study, which we intend to do in order to write more accurate forensic reports. With this study, it is aimed to increase the awareness of newly graduated medical students and emergency physicians about forensic reports and thus to keep their knowledge about the subject up-to-date.MethodsOur study was carried out retrospectively in Bezmialem Vakıf University Faculty of Medicine Emergency Service after approval of the Ethics Committee. The study was completed by examining the forensic reports written between 01.09.2020 and 30.09.2020.ResultsThe ratio of forensic cases admitted to the total number of patients within a one-month period was approximately 2.6%. The decrease in the number of emergency services due to COVID-19 and other restrictive measures may have decreased the rate of forensic cases admitted (4, 5). In our study, 78.9% (157 people) of forensic cases were men and the mean age was 34.26 ± 11.89. The proportion of women was 21.1% and the mean age was 37.21 ± 12.54. Men are more present in traffic than women. They work in high-risk jobs and have higher rates of alcohol use and substance abuse. For this reason, men are more involved in forensic cases (6). Among the forensic case reasons, 32.2% (64 people) of traffic accidents were the first. In other studies examined, traffic accidents were in the first place as well (7). The second most common reason for men was abuse (19 people), and poisoning for women (10 people) (Table 1). The area with the most frequent injuries was the upper extremity with a rate of 56.3% (112 people), followed by lower extremity (33.2%- 66 people), head- neck (23.1%- 46 people), thorax- back (22.6%- 45 people), abdomen (10.1%- 20 people), pelvis (8.5%- 17 people) and genital area (0.5%- 1 person) (Table 2). 35.2% (70 people) of the reports were prepared due to work related accidents. 87.1% of these cases were men. While the most common cause of work related accidents in males was cuts (49%), it was blunt trauma in females (44%). Only 12.1% of the reports written in the emergency department were written as definitive reports. Temporary forensic reports were prepared for the remaining 175 cases. One of the common problems with forensic reports is that the physician gives a temporary report when he/she is able to give a definitive report (5). It was seen that 50.8% of the reports mentioned if the injury was life-threatening or not. It was stated at a rate of 60.3% whether the injury could be relieved by a simple medical intervention or not. These ratios show that information should be given about the reason for the preparation of the report and its legal dimension. In forensic reports, the answers that are generally expected from the emergency physician are whether the person is life-threatening and whether he/she will recover with simple medical intervention. The deficiencies observed in the preparation of the forensic report can be seen as a neglect of duty for the physician. Emergency physicians should know how to write a forensic report and what their responsibilities are in this regard. Forensic reports must be filled in carefully, detailed and accurately.Student: Kerem Kara 160101066Mentor: Dr.Öğr.Üyesi Bahadır TAŞLIDEREReferences1. Aktas N, Gulacti U, Lok U, Aydin İ, Borta T, Celik M. Characteristics of the Traumatic Forensic Cases Admitted To Emergency Department and Errors in the Forensic Report Writing. Bull Emerg Trauma. 2018 Jan;6(1):64-702 . Bozkurt S, Daraoğlu V, Okumuş M, Savrun A, Karanfil R, Gök AA. Acil Serviste Düzenlenen Adli Raporların Uygunluğunun Değerlendirilmesi ve Tespit Edilen Eksiklikler. Journal of Clinical and Analytical Medicine, 2015;6: 331-43. Küçük E, Günel C. Demographic characteristics of forensic ınvestigation in emergency service. Sakarya Medical Journal. 2016;6(2):100-105. 4. Kukul Güven FM, Bütün C, Yücel Beyaztaş F, Eren Ş, Korkmaz İ. Cumhuriyet üniversitesi tıp fakültesi hastanesine başvuran adli olguların değerlendirilmesi. ADÜ Tıp Fakültesi Dergisi. 2009;10(3):23-28. 5. Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Evaluation of the forensic patients presenting to the emergency department and legal reports. Haseki Tip Bulteni. 2019;50:14-20.6. Crane CA, Godleski SA, Przybyla SM, Schlauch RC, Testa M. The Proximal Effects of Acute Alcohol Consumption on Male-to-Female Aggression: A Meta-Analytic Review of the Experimental Literature. Trauma Violence Abuse. 2016 Dec;17(5):520-531 7. Serinken M, Turkcuer İ, Acar K, Ozen M. Evaluation of medicolegal reports written by physicians in the emergency unit with regard to deficiencies and mistakes. Ulus Travma Acil Cerrahi Derg 2011;17:23-8.
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Kara K., Taşlıdere B., -Bezmialem Vakıf Üniversitesi Hastanesi Acil Servisine Başvuran Adli Nitelikli Olguların ve Adli Raporların Değerlendirilmesi -, 13. ULUSAL TRAVMA VE ACİL CERRAHİ KONGRESİ, İstanbul, Türkiye, 11 - 12 Aralık 2021, ss.1
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