The Prevalence of Trauma Injuries From Neighboring Countries Transferred to Iran

Document Type: Original Article

Authors

Trauma Research Center, Baqiyatallah University of Medical Sciences, Teharan, Iran

Abstract

Introduction: In recent years, the prevalence of attacks perpetrated by humans against other humans has increased worldwide. The injuries suffered by attack victims are severe and multi-organ. Iran’s neighboring countries have been the scenes of attacks in the recent past. This study assessed the type and severity of injuries sustained by victims transferred to Iran during the time period 2005-2007.
Methods: This study was conducted on injured civilians transferred to hospitals in Iran. Data regarding cause of injury, type and severity of injuries, diagnostic-therapeutic interventions, and patient outcomes was collected and statistically analyzed using SPSS version 14 software.
Results: In the studied time period, 214 attack victims were transferred to 3 Level 1 trauma centers in Iran. The mechanisms of injury were explosion in 130 cases, gunshot in 48, and other causes in the remaining victims. The mean Injury Severity Score (ISS) was 5.91 ± 4.54 (range = 1-34), and the median was 4; 109 cases (51%) had an ISS between 1 and 8, 73 cases (34%) were scored between 9 and 14, 15 cases (7%) were scored from 16 to 24, and 17 cases (8%) had an ISS ≥25. In terms of the number of injured organs, 42 patients (20%) had one, 124 (58%) had 2, 36 (17%) had 3, and 12 patients (5%) had 4 or more injured organs. Procedures included 86 orthopedic, 25 general surgical, 21 ear, nose, and throat (ENT), 18 plastic, 15 neurosurgical, and 10 ophthalmic operations; 25 patients received psychiatric counseling. The mean (±SD) hospital stay was 13.43 (±19.76) days (range = 1-230).
Conclusion: The injury pattern in attacks is more severe and differs from other traumas. The medical team should have adequate knowledge in this respect to provide comprehensive healthcare.

Keywords

References

  1. Jordan FB. The role of the medical examiner in mass casualty situations with special reference to the Alfred P. Murrah Building bombing. J Okla State Med Assoc. 1999;92(4):159-163.
  2. Rignault DP, Deligny MC. The 1986 terrorist bombing experience in Paris. Ann Surg. 1989;209(3):368-373. doi:10.1097/00000658-198903000-00019.
  3. Janak JC, Orman JA, Soderdahl DW, Hudak SJ. Epidemiology of Genitourinary Injuries among Male U.S. Service Members Deployed to Iraq and Afghanistan: Early Findings from the Trauma Outcomes and Urogenital Health (TOUGH) Project. J Urol. 2017;197(2):414-419. doi:10.1016/j.juro.2016.08.005.
  4. Kluger Y. Bomb explosions in acts of terrorism--detonation, wound ballistics, triage and medical concerns. Isr Med Assoc J. 2003;5(4):235-240.
  5. Kluger Y, Peleg K, Daniel-Aharonson L, Mayo A. The special injury pattern in terrorist bombings. J Am Coll Surg. 2004;199(6):875-879. doi:10.1016/j.jamcollsurg.2004.09.003.
  6. Arafat S, Alsabek MB, Ahmad M, Hamo I, Munder E. Penetrating abdominal injuries during the Syrian war: Patterns and factors affecting mortality rates. Injury. 2017;48(5):1054-1057. doi:10.1016/j.injury.2017.02.005.
  7. Bahouth H, Ghantous Y, Rachmiel A, Amodi O, Abu-Elnaaj I. Maxillofacial Injuries Related to the Syrian War in the Civilian Population. J Oral Maxillofac Surg. 2017;75(5):995-1003. doi:10.1016/j.joms.2017.01.007.
  8. Eastridge BJ, Jenkins D, Flaherty S, Schiller H, Holcomb JB. Trauma system development in a theater of war: Experiences from Operation Iraqi Freedom and Operation Enduring Freedom. J Trauma. 2006;61(6):1366-1372. doi:10.1097/01.ta.0000245894.78941.90.
  9. Hogan DE, Waeckerle JF, Dire DJ, Lillibridge SR. Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med. 1999;34(2):160-167. doi:10.1016/S0196-0644(99)70224-6.
  10. Leibovici D, Gofrit ON, Stein M, et al. Blast injuries: bus versus open-air bombings--a comparative study of injuries in survivors of open-air versus confined-space explosions. J Trauma. 1996;41(6):1030-1035. doi:10.1097/00005373-199612000-00015.
  11. Khoshmohabat H, Rasouli HR, Danial Z, Ghane MR. Validation of an Iranian Trauma Data Collection Form. Trauma Mon. 2016;21(5):e24686. doi:10.5812/traumamon.24686.
  12. Phillips Y, Richmond DR. Blast injury and basic research: a brief history. In: The Textbook of Military Medicine—Conventional Warfare: Ballistic, Blast, and Burn Injuries. Washington, DC: Department of the Army, Office of the Surgeon General; 1991: 221-40.
  13. Brismar B, Bergenwald L. The terrorist bomb explosion in Bologna, Italy, 1980: an analysis of the effects and injuries sustained. J Trauma. 1982;22(3):216-220. doi:10.1097/00005373-198203000-00007.
  14. Caro D, Irving M. The old Bailey bomb explosion. Lancet. 1973;1(7817):1433-1435. doi:10.1016/S0140-6736(73)91753-4.
  15. Mallonee S, Shariat S, Stennies G, Waxweiler R, Hogan D, Jordan F. Physical injuries and fatalities resulting from the Oklahoma City bombing. Jama. 1996;276(5):382-387. doi:10.1001/jama.1996.03540050042021.
  16. Tucker K, Lettin A. The Tower of London bomb explosion. Br Med J. 1975;3(5978):287-290. doi:10.1136/bmj.3.5978.287.
  17. Arnold JL, Halpern P, Tsai MC, Smithline H. Mass casualty terrorist bombings: a comparison of outcomes by bombing type. Ann Emerg Med. 2004;43(2):263-273. doi:10.1016/S0196064403007236.
  18. Propper BW, Rasmussen TE, Davidson SB, et al. Surgical response to multiple casualty incidents following single explosive events. Ann Surg. 2009;250(2):311-315. doi:10.1097/SLA.0b013e3181ae34a2.
  19. Turegano-Fuentes F, Caba-Doussoux P, Jover-Navalon JM, et al. Injury patterns from major urban terrorist bombings in trains: the Madrid experience. World J Surg. 2008;32(6):1168-1175. doi:10.1007/s00268-008-9557-1.
  20. Frykberg ER, Tepas JJ 3rd. Terrorist bombings. Lessons learned from Belfast to Beirut. Ann Surg. 1988;208(5):569-576. doi:10.1097/00000658-198811000-00005.
  21. Quenemoen LE, Davis YM, Malilay J, Sinks T, Noji EK, Klitzman S. The World Trade Center bombing: injury prevention strategies for high-rise building fires. Disasters. 1996;20(2):125-132. doi:10.1111/j.1467-7717.1996.tb00522.x.
  22. Hill JF. Blast injury with particular reference to recent terrorist bombing incidents. Ann R Coll Surg Engl. 1979;61(1):4-11.
  23. Singer P, Cohen JD, Stein M. Conventional terrorism and critical care. Crit Care Med. 2005;33(1 Suppl):S61-65. doi:10.1097/01.CCM.0000151068.33935.3E.
  24. Boehm TM, James JJ. The medical response to the LaBelle Disco bombing in Berlin, 1986. Mil Med. 1988;153(5):235-238.
  25. Moini M, Rezaishiraz H, Zafarghandi MR. Characteristics and outcome of injured patients treated in urban trauma centers in Iran. J Trauma. 2000;48(3):503-507. doi:10.1097/00005373-200003000-00023.
International Journal of Travel Medicine and Global Health

Volume 5, Issue 4
Autumn 2017
Page 140-143

Files

Histroty

  • Receive Date: 15 April 2017
  • Revise Date: 18 November 2017
  • Accept Date: 21 November 2017

Share

How to cite

Statistics