Vol 6, No 1 (2021)
Research paper
Published online: 2021-02-26

open access

Page views 482
Article views/downloads 426
Get Citation

Connect on Social Media

Connect on Social Media

Victims of terrorism-related disasters: experience of a hospital on the border of Iraq

Yunus Emre Ozluer1, Sinem Dogruyol2, Kıvanç Karaman3, Talha Dogruyol4
Disaster Emerg Med J 2021;6(1):26-32.

Abstract

INTRODUCTION: We aimed to analyze the data of patients who were admitted to our emergency department (ED) because of terrorism-related injuries.   MATERIAL AND METHODS: We have retrospectively analyzed the patients who were admitted to a state hospital’s ED with terrorism-related injuries between 01.01.2016 and 01.01.2018. The data about mechanism of injury, injured body part, Abbreviated Injury Scale scores, management, and outcomes: discharge from the ED, hospitalization to the ward, transfer to the operation room and/or intensive care unit, transfer to a tertiary hospital, the length of stay in the hospital, exitus, and re-admission were analyzed.   RESULTS: Of the 296 patients admitted, 93.9% were male and 6.1% were female, and 14.2% of the cases were children. Gunshot wounds represented 66.2% of the cases, whereas 33.8% of them had explosion injuries. Overall ED mortality rate was 15.5%. The mortality rate was higher in gunshot wounds. The most affected regions were the extremities, pelvis and external organs. Thorax injuries had the highest rate of mortality. Of the patients, 42.2% were discharged from the ED. The highest rate of ED discharge was with extremities, pelvis and external organ injuries. The ED mortality rate in the pediatric group was 21.4%. Gunshot wounded group had a higher mortality rate. Similar to adults the highest mortality rate was in the thoracic injury group.   CONCLUSIONS: Because of the variety of injuries, the management of terrorism victims requires a broad perspective. We think that the ED mortality rate can be used to assess the quality of the critical care provided.

Article available in PDF format

View PDF Download PDF file

References

  1. Nanninga P. Islam and Suicide Attacks. 2019.
  2. Evrin T, Demirel B, Yılmaz B, et al. Post-traumatic stress disorder after terrorist attack in healthcare professionals. Disaster and Emergency Medicine Journal. 2017; 2(1): 11–18.
  3. Index. Global Alert. 2015.
  4. Strang K, Alamieyeseigha S. What and Where are the Risks of International Terrorist Attacks. International Journal of Risk and Contingency Management. 2015; 4(1): 1–20.
  5. Haider AH, Chang DC, Haut ER, et al. Mechanism of injury predicts patient mortality and impairment after blunt trauma. J Surg Res. 2009; 153(1): 138–142.
  6. Madsen AS, Laing GL, Bruce JL, et al. A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service. Ann R Coll Surg Engl. 2016; 98(7): 488–495.
  7. Covey DC. Blast and fragment injuries of the musculoskeletal system. J Bone Joint Surg Am. 2002; 84(7): 1221–1234.
  8. Hanoch J, Feigin E, Pikarsky A, et al. Stab wounds associated with terrorist activities in Israel. JAMA. 1996; 276(5): 388–390.
  9. Rivkind AI, Blum R, Gershenstein I, et al. Trauma care and case fatality during a period of frequent, violent terror attacks and thereafter. World J Surg. 2012; 36(9): 2108–2118.
  10. Mikton CR, Butchart A, Dahlberg LL, et al. The world report on violence and health. Lancet. 2002; 360(9339): 1083–1088.
  11. Global Terrorism Index 2014. Human Rights Documents Online. .
  12. START: National Consortium for the Study of Terrorism and Responses to Terrorism. Choice Reviews Online. 2014; 51(12): 51-6530-51–6530.
  13. Peleg K, Aharonson-Daniel L, Michael M, et al. Israel Trauma Group. Patterns of injury in hospitalized terrorist victims. Am J Emerg Med. 2003; 21(4): 258–262.
  14. Sambasivan CN, Underwood SJ, Cho SD, et al. Comparison of abdominal damage control surgery in combat versus civilian trauma. J Trauma. 2010; 69 Suppl 1: S168–S174.
  15. Amir LD, Aharonson-Daniel L, Peleg K, et al. Israel Trauma Group. The severity of injury in children resulting from acts against civilian populations. Ann Surg. 2005; 241(4): 666–670.
  16. Jaffe DH, Peleg K. Israel Trauma Group. Terror explosive injuries: a comparison of children, adolescents, and adults. Ann Surg. 2010; 251(1): 138–143.
  17. Peleg K, Aharonson-Daniel L, Stein M, et al. Israeli Trauma Group (ITG). Gunshot and explosion injuries: characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004; 239(3): 311–318.
  18. Mushtaque M, Mir MF, Bhat M, et al. Pellet gunfire injuries among agitated mobs in Kashmir. Ulus Travma Acil Cerrahi Derg. 2012; 18(3): 255–259.
  19. Hebrang A, Henigsberg N, Golem AZ, et al. [Care of military and civilian casualties during the war in Croatia]. Acta Med Croatica. 2006; 60(4): 301–307.
  20. Bala M, Shussman N, Rivkind AI, et al. The pattern of thoracic trauma after suicide terrorist bombing attacks. J Trauma. 2010; 69(5): 1022–8; discussion 1028.
  21. Gennarelli TA, Wodzin E. AIS 2005: a contemporary injury scale. Injury. 2006; 37(12): 1083–1091.
  22. Cornwell EE. Current concepts of gunshot wound treatment: a trauma surgeon's perspective. Clin Orthop Relat Res. 2003(408): 58–64.
  23. Avitzour M, Mintz Y, Liebergall M, et al. The burden of terrorism: high rate of recurrent hospital referrals. Injury. 2008; 39(1): 77–82.
  24. Akkucuk S, Aydogan A, Yetim I, et al. Surgical outcomes of a civil war in a neighbouring country. J R Army Med Corps. 2016; 162(4): 256–260.



Disaster and Emergency Medicine Journal