Explosive injuries due to terror attacks: 10-year clinical outcomes in an emergency department in the Middle East

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Public Health

Background:

• Explosive injuries from terror attacks pose a significant public health challenge.
• Understanding clinical characteristics and mortality factors is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate clinical features, injury patterns, and mortality predictors in patients with explosive injuries from terror attacks.
• To assess the prognostic value of trauma scores in this patient population.

Main Methods:

• Retrospective cohort study of 271 patients with explosion-related injuries.
• Data extracted from electronic medical records and verified via chart review.
• Injury severity assessed using Injury Severity Score (ISS), Revised Trauma Score (RTS), and Shock Index (SI); ROC analysis used for prognostic evaluation.

Main Results:

• Mortality rate was 13% (36 patients).
• Non-survivors had lower GCS and RTS scores, higher ISS, and increased rates of ICU admission, intubation, transfusion, and amputation.
• RTS (AUC: 0.979) and ISS (AUC: 0.910) demonstrated high predictive accuracy for mortality.

Conclusions:

• Explosive terror attack injuries lead to high morbidity and mortality, particularly with central injuries and high trauma severity.
• ISS and RTS are valuable for early prognostic assessment in these patients.
• Prompt triage, surgical intervention, and critical care are vital for improving outcomes.