Cases Under the Age of 18 who Are Determined to Have Died due to Firearm Injury at Şanlıurfa Forensic Medicine Branch Directorate Examination
Öz
Objective: Child deaths due to gunshot wounds, which are rare in Turkey have become widespread in recent years; We aimed to examine sociodemographic, clinical and crime scene information in autopsied cases.
Materials and Methods: 58 cases of children under the age of 18 who were autopsied as a result of gunshot wounds were identified at the Forensic Medicine Institute Şanlıurfa Branch Directorate between January 1, 2013 and January 1, 2023. Children’s hospital files, autopsy reports, autopsy photographs and videos, chemical analysis reports of samples taken from the body, histopathological examination reports, crime scene reports, witness-defendant statements and expert reports were examined retrospectively. The data obtained in the study were analyzed statistically using IBM SPSS Statistics vn 20.0 software.
Results: In Şanlıurfa, where Turkey’s child population rate and child mortality rate are highest, children who died as a result of gunshot wounds; The average age was 12.78±4.63 and 70.7% were male. 50% of the deaths occurred during the pandemic period (2020-2021), and deaths occurred most frequently in winter (31%), in rural areas (81%), and as a result of injuries at home (60.4%). It was determined that the injuries frequently occurred as a result of a single shot with a short-barreled weapon (56.9%), most frequently in the head and neck region (48.2%), from the adjacent shooting range (37.9%), as a result of unintentional injury (50%), and resulted in death after medical intervention (63.8%).
Conclusion: The limited studies on child firearm injuries with high mortality in our country should be increased. Suicides can be reduced by performing psychological autopsies in deaths resulting from gunshot wounds that occur during adolescence. We also believe that deaths will decrease as a result of measures and training to reduce the accessibility of weapons in early childhood, when curiosity and exploration are high.
Anahtar Kelimeler
Etik Beyan
Çalışma için Adalet Bakanlığı Adli Tıp Kurumu Başkanlığı Eğitim ve Bilimsel Araştırma Komisyonu'ndan onay (10.05.2023 tarihli ve Karar no:21589509/2023/416) alınmıştır.
Destekleyen Kurum
Yok.
Kaynakça
- Rosenberg ML, Rodriguez JG, Chorba TL. Childhood injuries: Where we are. Pediatrics. 1990;86(6):1084-1091.
- Vatansever G, Yılmaz H, Nalbant T, Kanğin M, Almış H, Köker A, et al. Clinical characteristics of firearm-related injuries in children in Turkey. The Turkish journal of pediatrics. 2022;64(6):971-984. doi: 10.24953/turkjped.2021.4564.
- Fatal injury and violence data | WISQARS | injury center | CDC. Pub-lished February 10, 2022. Accessed May 15, 2022. https://www.cdc.gov/injury/ wisqars/fatal.html .
- DiMaggio C, Avraham J, Berry C, Bukur M, Feldman J, Klein M, et al. Changes in US mass shooting deaths associated with the 1994-2004 federal assault weapons ban: Analysis of open-source data. J Trauma Acute Care Surg. 2019;86(1):11-19. doi: 10.1097/TA.0000000000002060.
- Newgard CD, Kuppermann N, Holmes JF, Haukoos, JS, Wetzel B, Hsia RY et al. Gunshot injuries in children served by emergency services. Pediatrics. 2013;132:862-870. https://doi. org/10.1542/peds.2013-1350.
- Sofer D. Gun violence and children. Am J Nurs. 2017;117:114. https://doi.org/10.1097/01. naj.0000524529.50050.7b
- Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. N Engl J Med. 2022;386(20):1955-1956. doi: 10.1056/NEJMc2201761.
- Cunningham RM, Walton MA, Carter PM. The major causes of death in chil-dren and adolescents in the United States. N Engl J Med. 2018;379(25):2468-2475. doi: 10.1056/NEJMsr1804754.
- Fowler KA, Dahlberg LL, Haileyesus T, Gutierrez C, Bacon S. Childhood firearm in-juries in the United States. Pediatrics 2017;140(1):e20163486 Pediatrics. 2017;140(4):e20172298. doi: 10.1542/peds.2017-2298.
- Smith ER, Shapiro G, Sarani B. Fatal wounding pattern and causes of poten-tially preventable death following the pulse night club shooting event. Pre-hospital Emerg Care Off J Natl Assoc EMS Phys Natl Assoc State EMS Dir. 2018;22(6):662-668. doi: 10.1080/10903127.2018.1459980
- https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Cocuk-2020-37228 (ET:21.07.2023).
- Andrews AL, Killings X, Oddo ER, Gastineau KA, Hink AB. Pediatric firearm injury mortality epidemiology. Pediatrics. 2022;149(3), e2021052739. DOI: 10.1542/peds.2021-052739.
- Swendiman RA, Hatchimonji JS, Allukian M, Blinman TA, Nance ML, Nace GW. Pediatric firearm injuries: anatomy of an epidemic. Surgery. 2020;168(3):381-384. DOI: 10.1016/j.surg.2020.02.023.
- Zeybek V, Ata Öztürk HK, Seydaoğulları Baltacı A, Acar K. Denizli’de Meydana Gelen 0-18 Yaş Grubu Adli Ölümlerin Retrospektif Değerlendirilmesi. Turkiye Klinikleri Journal of Forensic Medicine & Forensic Sciences. 2022;19(2).
- Faruk A. Ateşli Silah Yaralanmasına Bağlı 18 Yaş Altı Ölümler. Uzmanlık Tezi, Manisa Celal Bayar Üniversitesi, Manisa, 2019.
- Demirci Ş, Doğan KH, Deniz İ, Büken B, Erkol Z. Konya’da çocukluk çağında meydana gelen ateşli silah yaralanmasına bağlı ölümler. Adli Tıp Bülteni. 2009;14(1):22-29.
- Georgeades C, Flynn-O’Brien KT. The effects of the COVID-19 pandemic on violent injuries in children: a literature review. Adv Pediatr. 2023;70(1):17-44. doi: 10.1016/j.yapd.2023.03.002. Epub 2023 Apr 4.
- Isometsä ET. Psychological autopsy studies-a review. European psychiatry. 2001;16(7):379-385. doi: 10.1016/s0924-9338(01)00594-6.
- Gonenir Erbay L, Karlidag R, Oruc M, Cigremis Y, Celbis O. Association of BDNF/TrkB and NGF/TrkA levels in postmortem brain with major depression and suicide. Psychiatria Danubina. 2021;33(broj 4):491-498. doi: 10.24869/psyd.2021.491.
- McLoughlin RJ, Hazeltine M, Dacier BM, Hirsh MP, Cleary MA, Aidlen JT. Young lives cut short: The relationship between firearms and pediatric suicide. J Trauma Acute Care Surg. 2019;87:161e167. doi: 10.1097/TA.0000000000002257.
- Roberts B, James D, Haft J, Balakrishnan N, Prince J, Sathya C. Wounding patterns in pediatric firearm fatalities. Injury. 2023;54(1):154-159. doi: 10.1016/j.injury.2022.11.072. Epub 2022 Dec 5.
- Maragkos GA, Papavassiliou E, Stippler M, Filippidis AS. Civilian gunshot wounds to the head: prognostic factors affecting mortality: meta-analysis of 1774 patients. J Neurotrauma. 2018;35(22):2605-2614. doi: 10.1089/neu.2018. 5682
- Flaherty MR, Klig JE. Firearm-related injuries in children and adolescents: an emergency and critical care perspective. Curr Opin Pediatr. 2020;32:349-353. doi: 10.1097/MOP.0000000000000905.
- DiScala C, Sege R. Outcomes in children and young adults who are hospitalized for firearms-related injuries. Pediatrics. 2004;113:1306-1312. https://doi. org/10.1542/peds.113.5.1306.
Şanlıurfa Adli Tıp Şube Müdürlüğünde Ateşli Silah Yaralanması Sonucu Öldüğü Belirlenen 18 Yaş Altı Olguların İncelenmesi
Öz
Amaç: Türkiye’de nadir görülen ancak son yıllarda yaygınlaşan ateşli silah yaralanmalarına bağlı çocuk ölümlerinde; otopsisi yapılan vakalarda sosyodemografik, klinik ve olay yeri bilgilerini incelemeyi amaçladık.
Gereç ve Yöntem: Adli Tıp Kurumu Şanlıurfa Şube Müdürlüğü’nde 1 Ocak 2013-1 Ocak 2023 tarihleri arasında ateşli silah yaralanması sonucu otopsisi yapılan 18 yaş altı 58 vaka belirlendi. Çocukların hastane dosyaları, otopsi raporları, otopsi fotoğrafları ve videoları, vücuttan alınan örneklerin kimyasal analiz raporları, histopatolojik inceleme raporları, olay yeri raporları, tanık-sanık ifadeleri ve bilirkişi raporları geriye dönük olarak incelendi. Çalışmada elde edilen veriler, IBM SPSS Statistics vn 20.0 yazılımı kullanılarak istatistiksel olarak analiz edildi.
Bulgular: Türkiye’nin çocuk nüfus oranının ve çocuk ölüm hızının en yüksek olduğu Şanlıurfa’da, ateşli silah yaralanması sonucu ölen çocukların; yaş ortalaması 12.78±4.63 olup %70.7’si erkekti. Ölümlerin %50’si pandemi döneminde (2020-2021) olup, ölümler en sık kışın (%31), kırsal bölgede (%81), ev içinde (%60.4) yaralanma sonucu meydana gelmişti. Yaralanmaların sıklıkla kısa namlulu silahla (%56.9) tek atışta en sık baş-boyun bölgesinden (%48.2) bitişik atış mesafesinden (%37.9) kasıtsız yaralanma (%50) sonucu gerçekleştiği ve tıbbi müdahale sonrasında (%63.8) ölümle sonuçlandığı belirlendi.
Sonuç: Ülkemizde mortalitesi yüksek çocuk ateşli silah yaralanmaları ile ilgili kısıtlı çalışmaların arttırılmalıdır. Ergenlik döneminde meydana gelen ateşli silah yaralanması sonucu ölümlerde psikolojik otopsiler yapılarak intiharlar azaltılabilir. Ayrıca merak ve keşfetme duyguları yüksek erken çocukluk döneminde silahlara ulaşılabilirliğin azaltılmasına yönelik önlem ve eğitimler verilmesi sonucu ölümlerin azalacağına inanıyoruz.
Anahtar Kelimeler
Kaynakça
- Rosenberg ML, Rodriguez JG, Chorba TL. Childhood injuries: Where we are. Pediatrics. 1990;86(6):1084-1091.
- Vatansever G, Yılmaz H, Nalbant T, Kanğin M, Almış H, Köker A, et al. Clinical characteristics of firearm-related injuries in children in Turkey. The Turkish journal of pediatrics. 2022;64(6):971-984. doi: 10.24953/turkjped.2021.4564.
- Fatal injury and violence data | WISQARS | injury center | CDC. Pub-lished February 10, 2022. Accessed May 15, 2022. https://www.cdc.gov/injury/ wisqars/fatal.html .
- DiMaggio C, Avraham J, Berry C, Bukur M, Feldman J, Klein M, et al. Changes in US mass shooting deaths associated with the 1994-2004 federal assault weapons ban: Analysis of open-source data. J Trauma Acute Care Surg. 2019;86(1):11-19. doi: 10.1097/TA.0000000000002060.
- Newgard CD, Kuppermann N, Holmes JF, Haukoos, JS, Wetzel B, Hsia RY et al. Gunshot injuries in children served by emergency services. Pediatrics. 2013;132:862-870. https://doi. org/10.1542/peds.2013-1350.
- Sofer D. Gun violence and children. Am J Nurs. 2017;117:114. https://doi.org/10.1097/01. naj.0000524529.50050.7b
- Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. N Engl J Med. 2022;386(20):1955-1956. doi: 10.1056/NEJMc2201761.
- Cunningham RM, Walton MA, Carter PM. The major causes of death in chil-dren and adolescents in the United States. N Engl J Med. 2018;379(25):2468-2475. doi: 10.1056/NEJMsr1804754.
- Fowler KA, Dahlberg LL, Haileyesus T, Gutierrez C, Bacon S. Childhood firearm in-juries in the United States. Pediatrics 2017;140(1):e20163486 Pediatrics. 2017;140(4):e20172298. doi: 10.1542/peds.2017-2298.
- Smith ER, Shapiro G, Sarani B. Fatal wounding pattern and causes of poten-tially preventable death following the pulse night club shooting event. Pre-hospital Emerg Care Off J Natl Assoc EMS Phys Natl Assoc State EMS Dir. 2018;22(6):662-668. doi: 10.1080/10903127.2018.1459980
- https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Cocuk-2020-37228 (ET:21.07.2023).
- Andrews AL, Killings X, Oddo ER, Gastineau KA, Hink AB. Pediatric firearm injury mortality epidemiology. Pediatrics. 2022;149(3), e2021052739. DOI: 10.1542/peds.2021-052739.
- Swendiman RA, Hatchimonji JS, Allukian M, Blinman TA, Nance ML, Nace GW. Pediatric firearm injuries: anatomy of an epidemic. Surgery. 2020;168(3):381-384. DOI: 10.1016/j.surg.2020.02.023.
- Zeybek V, Ata Öztürk HK, Seydaoğulları Baltacı A, Acar K. Denizli’de Meydana Gelen 0-18 Yaş Grubu Adli Ölümlerin Retrospektif Değerlendirilmesi. Turkiye Klinikleri Journal of Forensic Medicine & Forensic Sciences. 2022;19(2).
- Faruk A. Ateşli Silah Yaralanmasına Bağlı 18 Yaş Altı Ölümler. Uzmanlık Tezi, Manisa Celal Bayar Üniversitesi, Manisa, 2019.
- Demirci Ş, Doğan KH, Deniz İ, Büken B, Erkol Z. Konya’da çocukluk çağında meydana gelen ateşli silah yaralanmasına bağlı ölümler. Adli Tıp Bülteni. 2009;14(1):22-29.
- Georgeades C, Flynn-O’Brien KT. The effects of the COVID-19 pandemic on violent injuries in children: a literature review. Adv Pediatr. 2023;70(1):17-44. doi: 10.1016/j.yapd.2023.03.002. Epub 2023 Apr 4.
- Isometsä ET. Psychological autopsy studies-a review. European psychiatry. 2001;16(7):379-385. doi: 10.1016/s0924-9338(01)00594-6.
- Gonenir Erbay L, Karlidag R, Oruc M, Cigremis Y, Celbis O. Association of BDNF/TrkB and NGF/TrkA levels in postmortem brain with major depression and suicide. Psychiatria Danubina. 2021;33(broj 4):491-498. doi: 10.24869/psyd.2021.491.
- McLoughlin RJ, Hazeltine M, Dacier BM, Hirsh MP, Cleary MA, Aidlen JT. Young lives cut short: The relationship between firearms and pediatric suicide. J Trauma Acute Care Surg. 2019;87:161e167. doi: 10.1097/TA.0000000000002257.
- Roberts B, James D, Haft J, Balakrishnan N, Prince J, Sathya C. Wounding patterns in pediatric firearm fatalities. Injury. 2023;54(1):154-159. doi: 10.1016/j.injury.2022.11.072. Epub 2022 Dec 5.
- Maragkos GA, Papavassiliou E, Stippler M, Filippidis AS. Civilian gunshot wounds to the head: prognostic factors affecting mortality: meta-analysis of 1774 patients. J Neurotrauma. 2018;35(22):2605-2614. doi: 10.1089/neu.2018. 5682
- Flaherty MR, Klig JE. Firearm-related injuries in children and adolescents: an emergency and critical care perspective. Curr Opin Pediatr. 2020;32:349-353. doi: 10.1097/MOP.0000000000000905.
- DiScala C, Sege R. Outcomes in children and young adults who are hospitalized for firearms-related injuries. Pediatrics. 2004;113:1306-1312. https://doi. org/10.1542/peds.113.5.1306.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Adli Tıp |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 24 Ekim 2023 |
| Yayımlanma Tarihi | 1 Kasım 2023 |
| Gönderilme Tarihi | 12 Eylül 2023 |
| Kabul Tarihi | 25 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 5 Sayı: 3 |
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