Arnold Jeffrey L, Halpern Pinchas, Tsai Ming-Che, Smithline Howard
Department of Emergency Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
Ann Emerg Med. 2004 Feb;43(2):263-73. doi: 10.1016/s0196-0644(03)00723-6.
We compared the epidemiologic outcomes of terrorist bombings that produced 30 or more casualties and resulted in immediate structural collapse, occurred within a confined space, or occurred in open air.
We identified eligible studies of bombings through a MEDLINE search of articles published between 1966 and August 2002 and a manual search of published references. Pooled and median rates of mortality, immediately injured survival, emergency department use, hospitalization, and injury were determined for each bombing type.
We found 35 eligible articles describing 29 terrorist bombings, collectively producing 8,364 casualties, 903 immediate deaths, and 7,461 immediately surviving injured. Pooled immediate mortality rates were structural collapse 25% (95% confidence interval [CI] 6% to 44%), confined space 8% (95% CI 1% to 14%), and open air 4% (95% CI 0% to 9%). Biphasic distributions of mortality were identified in all bombing types. Pooled hospitalization rates were structural collapse 25% (95% CI 6% to 44%), confined space 36% (95% CI 27% to 46%), and open air 15% (95% CI 5% to 26%). Unique patterns of injury rates were found in all bombing types.
Patterns of injury and health care system use vary with the type of terrorist bombing.
我们比较了造成30人或更多伤亡、导致建筑物立即倒塌、发生在密闭空间或露天环境中的恐怖爆炸事件的流行病学结果。
我们通过对1966年至2002年8月发表的文章进行MEDLINE检索以及对已发表参考文献进行手工检索，确定了符合条件的爆炸事件研究。确定每种爆炸类型的合并死亡率、即时受伤存活率、急诊科使用率、住院率和受伤率的中位数。
我们发现35篇符合条件的文章描述了29起恐怖爆炸事件，共造成8364人伤亡，903人立即死亡，7461人即时存活受伤。合并即时死亡率为：建筑物倒塌25%（95%置信区间[CI]6%至44%），密闭空间8%（95%CI1%至14%），露天4%（95%CI0%至9%）。在所有爆炸类型中均发现了双相死亡率分布。合并住院率为：建筑物倒塌25%（95%CI6%至44%），密闭空间36%（95%CI27%至46%），露天15%（95%CI5%至26%）。在所有爆炸类型中均发现了独特的受伤率模式。
受伤模式和医疗保健系统的使用情况因恐怖爆炸类型而异。
