Incidence of traumatic intracranial hemorrhages requiring surgical treatment in KBC Sestre milosrdnica in the last five years

Traumatska intrakranijalna krvarenja (TIK). Jedna su od najčešćih kraniocerebralnih ozljeda koje u većini slučajeva zahtijevaju kirurško liječenje. Razlikujemo četiri vrste intrakranijalnih krvarenja: epiduralno krvarenje ili epiduralni hematom, subduralno krvarenje koje može biti akutno ili kronično, te subarahnoidalno, četvrta vrsta TIK su intracerebralna krvarenja koja predstavljaju krvarenja u sam parenhim mozga. Navedeni hematomi su udruženi s traumatskim nagnječenjima mozga. Razlikujemo krvarenja koji su posljedica traume i one koji nastaju spontano. Prijem takvih bolesnika najčešće je hitni te se bolesnik smješta u jedinicu intenzivnog liječenja ili priprema za operacijski zahvat. Cilj ovog diplomskog rada je ustanoviti incidenciju hitnih operacija bolesnika s TIK s obzirom na dobnu skupinu, spol i mjesto nastanka krvarenja u vremenskom periodu od 01.01.2017. do 31.12.2021. Prilikom postavljanja hipoteze pretpostavlja se da će biti uočena statistički značajna razlika s obzirom na promatrane dijagnoze, spol, životnu dob te godinu kad se desilo traumatsko intrakranijalno krvarenje. Podaci od 587 pacijenata koji su obuhvaćeni ovim istraživanjem prikupljeni su iz protokola izvršenih operacija u neurokirurškom operacijskom bloku za svakog pojedinog bolesnika., a obrađeni su u Microsoft Excelu 2019. Na prikupljenim podatcima učinjena je statistička analiza i obrada podataka te su prikazane povezanosti i razlike kod analiziranih pitanja na analizirane pokazatelje. Kategorijski podatci su predstavljeni apsolutnim i relativnim frekvencijama, a prikazani su tablično i grafički putem dijagrama. Razlike kategorijskih varijabli su testirane hi kvadrat testom, a po potrebi Fisherovim egzaktnim testom. Razina značajnosti bit će postavljena na 0,05. Pregledom podataka u vezanih za spol ispitanika može se uočiti kako je 64,7% ispitanika muškog spola, dok je 35,3% ispitanika ženskog spola, a kod dobnih kategorija 3,2% ima 16 – 29, 8,2% ima 30 – 50, 29,7% ima 51 – 70, dok 58,9% ima 71 i više godina. Kod dijagnoze 39,8% imalo je akutni subduralni, 37,9% kronični subduralni, a 7,7% epiduralni hematom, dok je 14,6% bio intracerebralni hematom. U zaključku ovog diplomskog rada osvrnula sam se na mogućnost poboljšanja kvalitete života bolesnika nakon kirurškog liječenja intrakranijalnih krvarenja a sve u svrhu postizanja njihovog osobnog zadovoljstva jer kraniocerebralne ozljede usprkos kontinuiranom liječenju mogu rezultirati velikim invaliditetom. Potpora obitelji oboljelog značajna je za oporavak bolesnika za vrijeme boravka u zdravstvenoj ustanovi ali i kod kuće. Važno je dakle obaviti edukaciju oboljelog i članova obitelji o specifičnostima bolesti, primjeni terapije i zdravstvene njege.Traumatic intracranial hemorrhage (TIH). They are one of the most common craniocerebral injuries that in most cases require surgical treatment. We distinguish four types of intracranial hemorrhages: epidural hemorrhage or epidural hematoma, subdural hemorrhage, which can be acute or chronic, and subarachnoid hemorrhage. The mentioned hematomas are associated with traumatic contusions of the brain. We distinguish between bleedings that are the result of trauma and those that occur spontaneously. Admission of such patients is usually urgent, and the patient is placed in the intensive care unit or prepared for surgery. The aim of this diploma thesis is to determine the incidence of emergency operations for patients with TIK with regard to age group, gender and place of bleeding in the period from 01.01.2017. until 31.12.2021. When setting up the hypothesis, it is assumed that a statistically significant difference will be observed with regard to the observed diagnoses, gender, age and the year when the traumatic intracranial hemorrhage occurred. Data from 587 patients included in this research were collected from the protocol of operations performed in the neurosurgical operating room for each individual patient, and were processed in Microsoft Excel 2019. A statistical analysis and data processing was performed on the collected data, and connections and differences between the analyzed questions and the analyzed indicators were presented. Categorical data are represented by absolute and relative frequencies, and are presented tabularly and graphically through diagrams. Differences in categorical variables were tested with the chi-square test and, if necessary, with Fisher's exact test. The significance level will be set at 0.05. By reviewing the data related to the gender of the respondents, it can be seen that 64.7% of the respondents are male, while 35.3% of the respondents are female, and in the age categories 3.2% are 16-29, 8.2% are 30- 50, 29.7% are 51-70, while 58.9% are 71 and older. At diagnosis, 39.8% had acute subdural, 37.9% chronic subdural, and 7.7% epidural hematoma, while 14.6% had intracerebral hematoma. In the conclusion of this thesis, I referred to the possibility of improving the quality of life of patients after surgical treatment of intracranial hemorrhages, all for the purpose of achieving their personal satisfaction, because craniocerebral injuries, despite continuous treatment, can result in severe disability. The support of the patient's family is important for the recovery of the patient during his stay in the health facility and at home. It is therefore important to educate the patient and family members about the specifics of the disease, the application of therapy and health care