İntihar girişimi nedeniyle niğde ömer halisdemir üniversitesi eğitim ve araştırma hastanesi'ne başvuran zehirlenme olgularının geriye dönük olarak değerlendirilmesi
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Tarih
2024
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Niğde Ömer Halisdemir Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: İntihar, kişinin yaşamına son verme amacıyla kasıtlı olarak yapmış olduğu, amacına ulaşma açısından başarı ile sonuçlanmış olan eylemdir. Söz konusu eylemin başarısız olması hali, intihar girişimi olarak adlandırılır. WHO verilerine göre meydana gelen ölümlerin tamamının %2'lik kısmını intihar vakaları oluşturmakta, dünyada her sene 1 milyondan fazla insan intihar sonucu hayatını kaybetmektedir. Bu yönüyle intihar, adli boyutu olan ciddi bir halk sağlığı sorunudur. Yapacağımız araştırmada zehirlenme yoluyla intihar girişiminde bulunmuş olan olguların bu davranışları ile kişilerin sahip oldukları sosyodemografik özellikler ve adli-tıbbi durumlar arasındaki ilişkilerin geriye dönük olarak değerlendirilmesi ve literatüre katkı sağlamak amaçlandı. Gereç ve Yöntem: Çalışmamızda 01/01/2019 ile 30/06/2023 tarihleri arasında intihar girişimi nedeniyle Niğde Ömer Halisdemir Üniversitesi Eğitim ve Araştırma Hastanesi'ne başvuran 214 zehirlenme olgusu çalışmaya dahil edilmiştir. Sonraki süreçte Adli Tıp Anabilim Dalımız tarafından kati rapor düzenlenmiş olan 214 zehirlenme olgusunun özellikleri geriye dönük olarak incelenmiştir. Bulgular: Vakaların 157 tanesi (%73.4) kadın cinsiyetiydi. 57 vaka (%26.6) erkek cinsiyetiydi. Olguların yaş ortalaması 26.7 ± 12.4 idi. Vakalarımızın 61 tanesi (%28.5) pediatrik olguydu. Olgularımızın 116 tanesi (%54.2) bekardı. 20 olgunun ise (%9.3) eşinden ayrıldığı veya eşinin vefat ettiği bulundu. Eğitim durumlarına göre değerlendirildiğinde, sadece 8 olgumuzun üniversite mezunu olduğunu tespit ettik. Olgularımızda ilaç olarak en sık NSAİ grubu ve antidepresan ilaçlarla intihar girişimi olduğu görüldü. Olgularımızın özgeçmişlerinde psikiyatrik hastalık olarak en sık anksiyete bozukluğu tanısı mevcuttu. İntihar girişimi nedeniyle hastanemiz acil servisine başvuran zehirlenme olgularına yönelik acil servis hekimi tarafından düzenlenmiş olan genel adli muayene raporları incelendi. 43 olguda (%20.1) söz konusu zehirlenmenin kişide hayati tehlikeye yol açmadığı şeklinde karar verildiği, 142 olguda (%66.4) hayati tehlikenin mevcut olduğu şeklinde karar verildiği görüldü. 29 olguda (%13.6) ise kişide hayati tehlikenin mevcut olup olmadığı konusunda herhangi bir görüş bildirilmediği tespit edildi. Sonuç: İntihar girişiminin tıbbi özgeçmiş ve demografik özellikler gibi birçok değişken ile ilişkili olduğunu, bu nedenle intihar amaçlı zehirlenme girişimlerinin sosyal, tıbbi ve adli boyutlar başta olmak üzere çok yönlü olarak değerlendirilmesi gerektiğini düşünüyoruz. Hekimlerin zehirlenme vakaları konusunda pozitif defansif tıp ve negatif defansif tıp uygulamalarına sıklıkla başvurduğu kanaatindeyiz. Zehirlenme vakalarının tıbbi yönünün haricinde, bütün zehirlenme olgularının adli vaka kapsamına girdiği unutulmamalıdır. Bu nedenle bu vakaların bir bütün olarak değerlendirilmesi gerekmektedir. Özellikle acil servislerde görev yapan hekimlerimizin adli tıbbi konularda yeterli bilgiye sahip olmadıkları kanaatindeyiz. Bu eksikliklerin mezuniyet sonrası eğitimlerle ve branşlar arası iletişimin kuvvetlendirilmesi ile giderilebileceğini düşünüyoruz. Anahtar Kelimeler: intihar, adli rapor, intoksikasyon, adli tıp, acil servis.
Introduction and Aim: Suicide is a deliberate action to end one's life, which has resulted in success in terms of achieving the goal. The failure of the action in question is called suicide attempt. According to WHO data, suicide cases account for 2% of all deaths and more than 1 million people die by suicide every year in the world. In this respect, suicide is a serious public health problem with a forensic dimension. In this study, we aimed to retrospectively evaluate the relationships between suicide attempts by intoxication and sociodemographic characteristics and forensic-medical conditions and to contribute to the literature. Materials and Methods: In our study, 214 poisoning cases admitted to Niğde Ömer Halisdemir University Training and Research Hospital due to suicide attempt between 01/01/2019 and 30/06/2023 were included in the study. In the following period, the characteristics of 214 poisoning cases in which a definitive report was issued by our department of forensic medicine were retrospectively analysed. Results: 157 cases (73.4%) were of female gender. 57 cases (26.6%) were male. The mean age of the cases was 26.7 ± 12.4 years. 61 (28.5%) of our cases were paediatric cases. 116 (54.2%) of our cases were single. 20 cases (9.3%) were separated from their spouses or their spouses were deceased. When evaluated according to educational status, we found that only 8 of our cases were university graduates. The most common drugs used in suicide attempts were NSAID group and antidepressant drugs. Anxiety disorder was the most common psychiatric disorder in our cases. General forensic examination reports prepared by the emergency physician for intoxication cases admitted to the emergency department of our hospital due to suicide attempt were analysed. In 43 cases (20.1%), the decision was made that the poisoning did not cause a life-threatening situation, and in 142 cases (66.4%), the decision was made that a life-threatening situation was present. In 29 cases (13.6%), it was determined that no opinion was given as to whether the person was in danger of life or not. Conclusion: We think that suicide attempts are associated with many variables such as medical history and demographic characteristics. Therefore, suicidal poisoning attempts should be evaluated in a multidimensional way, especially in social, medical and forensic dimensions. We believe that physicians frequently use positive defensive medicine and negative defensive medicine practices in poisoning cases. Apart from the medical aspect of poisoning cases, it should not be forgotten that all poisoning cases are forensic cases. Therefore, these cases should be evaluated as a whole. We believe that our physicians working especially in emergency services do not have sufficient knowledge on forensic medical issues. We think that these deficiencies can be overcome with post-graduation trainings and strengthening communication between branches. Keywords: suicide, forensic report, intoxication, forensic medicine, emergency department.
Introduction and Aim: Suicide is a deliberate action to end one's life, which has resulted in success in terms of achieving the goal. The failure of the action in question is called suicide attempt. According to WHO data, suicide cases account for 2% of all deaths and more than 1 million people die by suicide every year in the world. In this respect, suicide is a serious public health problem with a forensic dimension. In this study, we aimed to retrospectively evaluate the relationships between suicide attempts by intoxication and sociodemographic characteristics and forensic-medical conditions and to contribute to the literature. Materials and Methods: In our study, 214 poisoning cases admitted to Niğde Ömer Halisdemir University Training and Research Hospital due to suicide attempt between 01/01/2019 and 30/06/2023 were included in the study. In the following period, the characteristics of 214 poisoning cases in which a definitive report was issued by our department of forensic medicine were retrospectively analysed. Results: 157 cases (73.4%) were of female gender. 57 cases (26.6%) were male. The mean age of the cases was 26.7 ± 12.4 years. 61 (28.5%) of our cases were paediatric cases. 116 (54.2%) of our cases were single. 20 cases (9.3%) were separated from their spouses or their spouses were deceased. When evaluated according to educational status, we found that only 8 of our cases were university graduates. The most common drugs used in suicide attempts were NSAID group and antidepressant drugs. Anxiety disorder was the most common psychiatric disorder in our cases. General forensic examination reports prepared by the emergency physician for intoxication cases admitted to the emergency department of our hospital due to suicide attempt were analysed. In 43 cases (20.1%), the decision was made that the poisoning did not cause a life-threatening situation, and in 142 cases (66.4%), the decision was made that a life-threatening situation was present. In 29 cases (13.6%), it was determined that no opinion was given as to whether the person was in danger of life or not. Conclusion: We think that suicide attempts are associated with many variables such as medical history and demographic characteristics. Therefore, suicidal poisoning attempts should be evaluated in a multidimensional way, especially in social, medical and forensic dimensions. We believe that physicians frequently use positive defensive medicine and negative defensive medicine practices in poisoning cases. Apart from the medical aspect of poisoning cases, it should not be forgotten that all poisoning cases are forensic cases. Therefore, these cases should be evaluated as a whole. We believe that our physicians working especially in emergency services do not have sufficient knowledge on forensic medical issues. We think that these deficiencies can be overcome with post-graduation trainings and strengthening communication between branches. Keywords: suicide, forensic report, intoxication, forensic medicine, emergency department.
Açıklama
Tıp Fakültesi, Adli Tıp Ana Bilim Dalı
Anahtar Kelimeler
Adli Tıp, Forensic Medicine
