Terror-related injuries: a comparison of gunshot wounds versus secondary-fragments-induced injuries from explosives.

Full Abstract

BACKGROUND:
Terror-related injuries caused by secondary fragments (SF) from explosive devices show a distinctive pattern in severity, distribution, outcomes of assault, and health-system resource use as compared with terror-related penetrating injuries caused by gunshot wounds.

STUDY DESIGN:
A case-comparison study conducted in a tertiary university hospital and the only Level I trauma center in the Jerusalem vicinity. During a period of 4 years, over 1,500 casualties of terror-related injuries were treated in one Level I trauma center. The study included 533 patients who were admitted for hospitalization. Excluded from the study were victims who were dead on arrival or who succumbed to their injuries within 30 minutes of arrival at the emergency department. Data were collected from trauma registry records.

RESULTS:
Gunshot-wound victims were mostly men, aged 19 to 30, and SF victims were more evenly distributed between the genders and across the age spectrum. Injury Severity Score (ISS) was considerably higher in SF victims, although critical mortality rates were higher in gunshot-wound victims. More than 40% of SF victims were injured in three or more body regions, as opposed to < 10% in gunshot-wound victims. Use of imaging modalities and ICUs was considerably higher for SF victims.

CONCLUSIONS:
Terror victims suffering from SF wounds have more complex, widespread, and severe injuries than victims suffering from gunshot wounds. They tend to involve multiple body regions and use more in-hospital resources. Attenuation of bus seats and protective vests can lead to a reduction in severity of these injuries.

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Author information

Author/s: Sheffy, Nadav (N); Mintz, Yoav (Y); Rivkind, Avraham I (AI); Shapira, Shmuel C (SC);

Affiliation: Department of Anesthesiology, Rabin Medical Center-Beilinson Campus, Petah-Tikva, Israel.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Journal of the American College of Surgeons (J Am Coll Surg), published in United States. (Language: eng)

Reference: 2006-Sep; vol 203 (issue 3) : pp 297-303

Dates: Created 2006/08/25; Completed 2006/10/06; Revised 2006/11/15;

PMID: 16931301, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Blast Injuries
Child
Child, Preschool
Explosions
Female
Hospitals - utilization
Humans

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