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master's thesis
Potres mozga sa sudsko-medicinskog aspekta
2018. urn:nbn:hr:171:015093
Vodanović, Matea
University of Split
School of Medicine
Forensic medicine

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Vodanović, M. (2018). Potres mozga sa sudsko-medicinskog aspekta (Master's thesis). Split: University of Split, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:171:015093

Vodanović, Matea. "Potres mozga sa sudsko-medicinskog aspekta." Master's thesis, University of Split, School of Medicine, 2018. https://urn.nsk.hr/urn:nbn:hr:171:015093

Vodanović, Matea. "Potres mozga sa sudsko-medicinskog aspekta." Master's thesis, University of Split, School of Medicine, 2018. https://urn.nsk.hr/urn:nbn:hr:171:015093

Vodanović, M. (2018). 'Potres mozga sa sudsko-medicinskog aspekta', Master's thesis, University of Split, School of Medicine, accessed 18 November 2024, https://urn.nsk.hr/urn:nbn:hr:171:015093

Vodanović M. Potres mozga sa sudsko-medicinskog aspekta [Master's thesis]. Split: University of Split, School of Medicine; 2018 [cited 2024 November 18] Available at: https://urn.nsk.hr/urn:nbn:hr:171:015093

M. Vodanović, "Potres mozga sa sudsko-medicinskog aspekta", Master's thesis, University of Split, School of Medicine, Split, 2018. Available at: https://urn.nsk.hr/urn:nbn:hr:171:015093

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Metadata
TitlePotres mozga sa sudsko-medicinskog aspekta
Title (english)Concussion diagnosis from a forensic point of view
AuthorMatea Vodanović
MentorMarija Definis-Gojanović (mentor)
Committee memberMeri Matijaca (predsjednik povjerenstva)
Committee memberŽeljko Bušić (član povjerenstva)
Committee memberRosanda Mulić (član povjerenstva)
GranterUniversity of Split
School of Medicine
(Forensic medicine)
Split
Defense date and country2018, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Forensic Medicine
Abstract
CILJEVI ISTRAŽIVANJA: Primarni cilj ovog istraživanja jest odrediti ukupan udio medicinske dokumentacije pacijenata kojima je dijagnosticiran potres mozga koja se ne može prihvatiti od strane sudskomedicinskog stručnjaka te prezentirati glavne probleme koji se javljaju kod vještačenja ovih dijagnoza. Sekundarni cilj istraživanja jest odrediti epidemiologiju ozljede potresa mozga u gradu Splitu za 2017. godinu. ISPITANICI I METODE: Provedena je retrospektivna studija pregledom otpusnih pisama pacijenata za razdoblje od 01.01.2017. do 31.12.2017. godine na Hitnom kirurškom prijemu KBC-a Split. Prezentirani uzorak je promatran s obzirom na vrijeme proteklo od nastupa ozljede do prvog pregleda pacijenta, simptome kojima se pacijent prezentira te odgovarajuću potvrdu i opis istih od strane liječnika, odstupanja u općem statusu pri pregledu pacijenta, odstupanja u neurološkom statusu, rezultat Glasgovske ljestvice kome te s obzirom na nalaze dodatnih učinjenih dijagnostičkih pretraga, s naglaskom na kompjutoriziranoj tomografiji. U medicinskoj dokumentaciji svakog pojedinog pacijenta analizirani su korišteni dijagnostički kriteriji te kritičnost i objektivnost liječnika pri postavljanju dijagnoze potresa mozga. Postavljena je nulta hipoteza koja glasi: Ukupno 95% nalaza je po sudskomedicinskim kriterijima ispravno napisano. Preostalih 5% nalaza ne može biti prihvaćeno pri vještačenju, što je posljedica vanjskih i unutarnjih faktora koji se pripisuju slučajnoj ljudskoj pogrešci. Svakom su pacijentu također analizirane i sljedeće karakteristike: kronološka dob u godinama, spol, mehanizam nastanka ozljede potresa mozga, pridružene ozljede, preporučena hospitalizacija i ordinirana terapija. Ovi podaci su potom uspoređeni sa svjetskom literaturom kako bi se utvrdile eventualne razlike u epidemiologiji. REZULTATI: Ukupan broj nalaza koji mogu biti prihvaćeni pri vještačenju bio je 37, što je statistički značajan rezultat (p<0,05) koji govori da pogreške pronađene pri pregledu medicinske dokumentacije nisu posljedica slučajnosti. Najveći broj ispitanika spada u dobnu kategoriju radno sposobne populacije od 18-64 godine. Pronađeno je da su muškarci pod većim rizikom od žena za nastanak ozljede potresa mozga, pri čemu su u obe skupine najčešći uzroci bili padovi i prometne nezgode. Ovi podaci su u skladu sa podacima iz svjetske literature. S obzirom na ukupan broj preporučenih hospitalizacija, preporuka liječnika za hospitalizaciju pacijenata kod kojih je jedina indikacija potres mozga pronađena je u 17 slučajeva. ZAKLJUČCI: Literatura bi uvelike beneficirala uvođenjem klasifikacijskog sustava ozljede potresa mozga. Do tada, kritičnost i objektivnost liječnika pri susretu s ovim pacijentima kao i praćenje suvremenih pravnih i medicinskih smjernica predstavljaju jedini način ispravnog dijagnosticiranja blage traumatske moždane ozljede. Stoga se dodatna edukacija liječničkog osoblja postavlja kao imperativ.
Abstract (english)
OBJECTIVES: The primary goal of this study is to determine how much medical documentation of the patients diagnosed with concussion cannot be accepted by a forensic expert and to present the main problems that occur when expertising this diagnosis. The secondary goal is to determine the epidemiology of concussion in the city of Split for the year of 2017. PATIENTS AND METHODS: This retrospective study was conducted by examining the leave letters of year 2017 in the Emergency Surgical Unit of the University Hospital of Split. Observed components of the presented sample were: time that had passed between the event and the first examination of the patient, symptoms which the patients were presenting (including their adequate confirmation and description by a doctor), deviations in somatic and neurological status of the patients, the result of GCS and the results of additional diagnostic tools with the emphasis on the CT. The used diagnostic criteria and the criticality and objectivity of the medical doctors were analysed in the medical documentation of every patient. Null hypothesis was set: 95% of the observed medical documentation of the patients is acceptable by a forensic expert, while the remaining 5% isn't; this is the consequence of external and internal factors attributed to standard accidental human error. The following characteristics were also analysed for every patient: sex and chronological age, the mechanism of concussion, associated injuries, recommended hospitalisation and recommended therapy. The acquired data was then compared with world literature in order to determine the differences in epidemiology. RESULTS: The total number of medical documentation accepted when expertising this diagnosis was 37, which represents a statistically significant result (p<0,05) and leads to a conclusion that the errors found were not accidental. The majority of the respondents fall to the group of work-capable population aged 18 to 64 years. It was found that men have greater risk for concussion than women, whereby in both sexes the most common cause of concussion were falls and traffic accidents. This data is in unison with the world literature data. Considering the total number of recommended hospitalisations, that in which the only indication is an injury of the patient resulting in concussion was found in 17 cases. CONCLUSIONS: Introducing and implementing a viable classification system for concussion would greatly benefit the existing literature. Until then, criticality and objectivity of medical doctors and following the modern legal and medical guidelines when meeting with these patients represent the only way of diagnosing concussion accurately. That is why additional education of the medical personnel is set as an imperativ.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:171:015093
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2018-11-26 14:04:12