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Penetrating abdominal injuries during the Syrian war: Patterns and factors affecting mortality rates.
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- Author(s): Arafat, Shawqi1 ; Alsabek, Mhd Belal1,2 ; Ahmad, Mousa3 ; Hamo, Iman3 ; Munder, Eskander3
- Source:
Injury. May2017, Vol. 48 Issue 5, p1054-1057. 4p.- Subject Terms:
*ABDOMINAL injuries; *SYRIAN War, 1839-1840; *DEATH rate; *INTENSIVE care units; *WAR casualties; *PATIENTS; *BLAST injury treatment; *DECISION making; *DISASTERS; *EMERGENCY medicine; *GUNSHOT wounds; *HOSPITAL emergency services; *PENETRATING wounds; *TRAUMATOLOGY; *ACQUISITION of data; *BLAST injuries; *RETROSPECTIVE studies; *TRAUMA severity indices; *THERAPEUTICS - Source:
- Additional Information
- Subject Terms:
- Abstract:
Background: A large number of innocent Syrians were injured or killed during the years of war. This retrospective study investigates the differences in patterns of injury and factors affecting the mortality rate in 324 patients coming to Damascus Hospital with penetrating abdominal trauma, and illustrates the difficulties of diagnosis and decision making in crisis situations.Methods: A retrospective study was registered from patient's records between October 2012 and June 2013 in Damascus Hospital. All victims were injured either by explosions or gunshots.Results: A total of 325 patients: 183 by explosion; 56.3%, 141 by gunshot; 43.3%, and one patient by other means; 0.3% were reviewed. The study focused on the two large groups with a total of 324 patients. Males were predominant (82.1%; n=266) and the majority of patients were between 19 and 35 years old. Patients suffering from multi abdominal organ injury were more common in gunshot group (n=72, 51.1%) compared to the explosion group (n=83, 45.3%). 264 patients (81.5%) underwent surgical operations and only 22 (8.3%) had normal laparotomy. The inpatient mortality rate was (17.0%; n=55), and there was no difference in mortality rate between the two groups. More than the half of deaths (n=42; 76.4%) had a P.A.T.I scoreā„25 where the death rate was 35.6% which is higher compared to 6.3% in those with a P.A.T.I<25. In the ICU 33 patients died, of these (87.9%; n=29) died after immediate admission to the ICU which is higher compared with a later admission (12.1%; n=4). The need for massive blood transfusion affected the mortality rate.Conclusion: Efforts must be directed toward training of medical staff to deal with crisis incidents. The need for massive blood transfusion and ICU admissions can affects mortality. P.A.T.I was found to be an effective predictor of mortality. Clinical experience in this field can produce better health care and faster judgments. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Injury is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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