Open Access Open Access  Restricted Access Subscription or Fee Access

Description of blast injuries and predictors of admission to hospital in blast victims in an urban civilian setting

Mazen J. El Sayed, MD, MPH, FAAEM, FACEP, Hady Zgheib, MD, Rana Bachir, MPH, Hussein Abou Ghaddara, MD

Abstract


Introduction: Blast injuries characteristics and outcomes are not well described in urban civilian settings.

Objectives: To describe blast injuries characteristics and to identify predictors of hospital admission after sustaining a blast injury.

Methods: Retrospective chart review study of blast victims who presented to the Emergency Department (ED) of a tertiary care center in Beirut, Lebanon, over 8 years. The authors conducted a descriptive analysis, followed by a multivariate analysis to identify predictors.

Results: A total of 59 patients were included. They were mostly males (81.4 percent) with a mean age of 35.4 ( ± 15) years with high rate of admission to the hospital (71.2 percent). Surface injury (mainly open wounds) was most common (91.5 percent). Injuries involved mainly the face (45.8 percent) and thigh/knee (33.9 percent). Significant associations were identified between different injury locations. Significant predictors of hospital admission in blast victims were internal injury (odds ratio [OR] = 11.6, 95% confidence interval [CI; 1.7, 79.9]), orthopedic injury (OR = 41.1, 95% CI [3.4, 496.2]), and undergoing a chest X-ray in the ED (OR = 14.3, 95% CI [2.2, 93.3]).

Conclusion: Blasts in a civilian setting result in a wide range of injuries. Facial injuries were most common in our setting with close associations between injuries of different organ systems. Identified predictors of hospital admission can help guide disposition decision for blast victims in the ED.


Keywords


blast injury, civilian, predictors, hospital admission, Lebanon

Full Text:

PDF

References


Satin RW, Sasser SM, Sullivent EE, et al.: The epidemiology and triage of blast injuries. In Elsayed NM, Atkins JL (Eds.): Explosion and Blast-Related Injuries: Effects of Explosion and blast from Military Operations and Acts of Terrorism. Burlington: Elsevier, 2007: 3-41.

Ramasamy A, Harrisson SE, Clasper JC, et al.: Injuries from roadside improvised explosive devices. J Trauma. 2008; 65(4): 910-914.

Benfield RJ, Mamczak CN, Vo KC, et al.: Initial predictors associated with outcome in injured multiple traumatic limb amputations: A Kandahar-based combat hospital experience. Injury. 2012; 43(10): 1753-1758.

Eskridge SL, Macera CA, Galarneau MR, et al.: Injuries from combat explosions in Iraq: injury type, location, and severity. Injury. 2012; 43(10): 1678-1682.

Martí M, Parrón M, Baudraxler F, et al.: Blast injuries from Madrid terrorist bombing attacks on March 11, 2004. Emerg Radiol. 2006; 13(3): 113-122.

Carli P, Telion C, Baker D: Terrorism in France. Prehosp Disaster Med. 2003; 18(2): 92-99.

Singer P, Cohen JD, Stein M: Conventional terrorism and critical care. Crit Care Med. 2005; 33(1 suppl): S61-S65.

Singh AK, Sodickson A, Abujudeh H: Imaging of abdominal and pelvic injuries from the Boston Marathon bombing. Emerg Radiol. 2016; 23(1): 35-39.

Bala M, Willner D, Keidar A, et al.: Indicators of the need for ICU admission following suicide bombing attacks. Scand J Trauma Resusc Emerg Med. 2012; 20: 19.

Barell V, Aharonson-Daniel L, Fingerhut LA, et al.: An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev. 2002; 8(2): 91-96.

Gennarelli T, Wodzon E: The Abbreviated Injury Scale—2005. Des Plaines, IL: Association for the Advancement of Automotive Medicine, 2005.

Aharonson-Daniel L, Klein Y, Peleg K: Suicide bombers form a new injury profile. Ann Surg. 2006; 244(6): 1018-1023.

Almogy G, Belzberg H, Mintz Y, et al.: Suicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004; 239(3): 295-303.

Kluger Y, Peleg K, Daaniel-Aharonson L, et al.: The special injury pattern in terrorist bombings. J Am Coll Surg. 2004; 199(6): 875-879.

Peleg K, Aharonson-Daniel L, Stein M, et al.: Gunshot and explosion injuries characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004; 239(3): 311-318.

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.

Rodoplu U, Arnold JL, Tokyay R, et al.: Impact of the terrorist bombings of the Neve Shalom and Beth Israel Synagogues on a hospital in Istanbul, Turkey. Acad Emerg Med. 2005; 12(2): 135-141.

Mallonee S, Shariat S, Stennies G, et al.: Physical injuries and fatalities resulting from the Oklahoma City bombing. JAMA. 1996; 276(5): 382-387.

Federal Emergency Management Agency (FEMA). Available at http://www.fema.gov/pdf/plan/prevent/rms/428/fema428_ch4.pdf. Accessed October 11, 2015.

Crabtree J: Terrorist homicide bombings: A primer for preparation. J Burn Care Res. 2006; 27(5): 576-588.

Boffard KD, MacFarlane C: Urban bomb blast injuries: Patterns of injury and treatment. Surg Ann. 1993; 25: 29-47.

Brunner J, Singh AK, Rocha T, et al.: Terrorist bombings: Foreign bodies from the Boston Marathon bombing. Semin Ultrasound CT MR. 2015; 36(1): 68-72.

Guermazi A, Hayashi D, Smith SE, et al.: Imaging of blast injuries to the lower extremities sustained in the Boston marathon bombing. Arthritis Care Res. 2013; 65: 1893-1898.




DOI: https://doi.org/10.5055/ajdm.2015.0213

Refbacks

  • There are currently no refbacks.