Injury spectrum of mass casualty terrorist bombing events
Objective To analyze the injury spectrum of mass casualty terrorist bombing events,and to pro-vide a theoretical basis for improving emergency rescue capacity.Methods Worldwide literature on mass casualty terrorist bombing events(defined as＞100 casualties)published until Dec.31st,2023 was collected from the data-bases of CNKI,Wanfang,VIP,PubMed,Web of Science,and Cochrane Database.The injury types,injury sites,sur-geries,and causes of death were systematically analyzed.Results A total of 32 mass casualty terrorist bombings e-vents were included in this study,with 16,826 casualties(including 6,602 wounded and 13,636 blast injuries,and 1003 surgical events.The average fatality rate of the 32 mass casualty events was 15.11％,which became higher when building collapse occurred.The injury types were mainly penetrating/tear injuries(35.59％),contusion/abra-sion(23.81％),fractures(6.69％),and ear blast injuries(6.41％).In terms of injury sites,head and neck(35.78％)and limbs(33.26％)accounted for the highest proportion,with chest and back(10.98％)ranking third.For limb injuries,the upper limb was less commonly affected than the lower limb(12.20％vs.16.40％).Most of the survivors had minor injuries,with an average hospitalization rate of 25.6％.Severely injured patients(defined as ISS≥ 16)accounted for 7.76％of the surviving wounded,while 25.55％of the hospitalized patients.The mortality rate of severely injured patients was 23.14％.Most of the in-hospital surgeries were soft tissue-related(47.86％),followed by orthopedic-related(23.23％),abdomen-related(14.86％),and chest-related(6.18％).The main causes of death in the severely injured patients after treatment were critical head trauma and multiple inju-ries,with the injury regions of head(40.85％),chest(26.76％),abdomen(18.31％)and limbs(14.08％)in sequence.Most deaths occurred within 48 h after admission,due to severe head trauma,penetrating chest and abdom-inal injuries and hemorrhagic shock;while the 1-week hospital deaths were mainly due to burns,infections,and mul-tiple organ failure.Conclusion Since the main cause of in-hospital death after a mass casualty terrorist bombing is severe trauma to the head and chest,and surgeries are mainly soft tissue-related,it is recommended to select cranial surgeons,thoracic surgeons and critical care medical experts to focus on the severely injured patients during rescue of mass casualty terrorist bombing events,while general surgery and orthopedics as the main treatment departments.
Terrorist bombingMass casualty incidentsInjury typesInjury siteSurgeryCause of death
万方数据
维普
