The structure of fatal closed injuries of the chest and abdomen according to the bureau of forensic medical examination of Kashkadarya region

Abstract

Aim. To study the structure and causes of death in closed chest and abdominal trauma based on autopsy
results in order to develop recommendations for reducing adverse outcomes in these types of injuries.
Material and methods. According to the Kashkadarya Bureau of Forensic Medical Examination for 2020–
2021, the results of pathoanatomic studies of 1830 deceased were analyzed. The proportion of deaths from
mechanical injury was 39.2% (717/1830), of which the proportion of blunt trauma was 84.2% (604/717).
Results. In severe blunt trauma, the frequency of damage to the chest and abdomen is 82.8% (500/604).
37.1% (224/604) have a combined lesion of the chest and abdomen. With chest and abdominal injuries
(n=500), 74.0% of the victims died at the scene of the accident, 13.6% died during transportation, and
12.4% died in hospital. Delivery of the victim by ambulance teams allows to reduce mortality during transportation (compared with delivery by passing vehicles) from 63.6 to 44.0%, as well as to reduce deaths
in the emergency department from 20.0 to 10.7%. 51.6% of patients with closed chest and abdominal
trauma delivered alive to the clinic die on the first day, a high risk of death (21.0%) persists for 4–14 days,
Shoshilinch tibbiyot axborotnomasi, 2023, 16-tom, № 1 15
19.4% of victims die later than 14 days. Doctors of district emergency departments (ED) were more prone
to overdiagnosis of possible injuries, which negatively affected the specificity (Sp 25.0% vs. 75.0% in the
RNCEMP branch) and the overall accuracy (Ac 79.5% vs. 88.9%) of diagnostic procedures. 13.6% of cases
of fatal damage to internal organs are not diagnosed in the ED, and therefore the NPV indicator (the prognostic value of a negative result) is reduced to 40.0% against 75.0% in the RRCEM branch.