Glenshaw Mary T, Vernick Jon S, Li Guohua, Sorock Gary S, Brown Sheryll, Mallonee Sue
Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
J Trauma. 2009 Feb;66(2):508-15. doi: 10.1097/TA.0b013e31815d9b72.
Terrorist bombings are an increasing source of violent death and injury worldwide. Injuries in building bombings have been previously reported in descriptive studies, but no comparative analyses have quantitatively assessed factors influencing the severity of nonfatal bombing injuries. The objective of this study was to identify personal and environmental risk factors for injury severity in the Oklahoma City bombing, on April 19, 1995.
We conducted a retrospective comparative analysis of 509 nonfatally injured occupants of four buildings surrounding the detonation site. The source of data was the 1995 Oklahoma City Bombing database, a registry of all injuries and fatalities related to the bombing. Multivariable logistic regression was used to assess two outcomes: (1) medically-attended injury among injured occupants; and (2) hospital admission among occupants with medically attended injuries.
Increased odds of sustaining medically attended injuries were associated with being struck by flying glass (adjusted odds ratio [AOR], 5.3; 95% confidence interval [CI], 1.9-14.8) and location above the first floor of buildings (OR, 4.0; 95% CI, 1.4-11.7) after adjustment for other factors. Adjusted odds of hospital admission were associated with location in the collapsed region (AOR, 43.4; 95% CI, 4.4-434.1), being blown by the blast wind (AOR, 5.3; 95% CI, 2.1-13.8), and being trapped (AOR, 3.1; 95% CI, 1.2-7.7).
The severity of nonfatal injury in the Oklahoma bombing was primarily associated with structural and environmental factors. Improved architectural design may prevent many injuries in building bombings. These finding provide evidence for future injury prevention activities.
恐怖主义爆炸事件在全球范围内导致暴力死亡和受伤的情况日益增多。此前已有描述性研究报道过建筑物爆炸中的受伤情况，但尚无比较分析对影响非致命爆炸伤严重程度的因素进行定量评估。本研究的目的是确定1995年4月19日俄克拉何马城爆炸事件中影响受伤严重程度的个人和环境风险因素。
我们对爆炸现场周围四栋建筑物中509名非致命受伤的居住者进行了回顾性比较分析。数据来源是1995年俄克拉何马城爆炸数据库，该数据库记录了与爆炸相关的所有伤亡情况。采用多变量逻辑回归来评估两个结果：（1）受伤居住者中接受医疗救治的损伤情况；（2）接受医疗救治的受伤居住者中的住院情况。
在对其他因素进行调整后，遭受医疗救治损伤的几率增加与被飞溅的玻璃击中（调整后的优势比[AOR]，5.3；95%置信区间[CI]，1.9 - 14.8）以及建筑物一楼以上的位置（优势比，4.0；95% CI，1.4 - 11.7）相关。调整后的住院几率与倒塌区域的位置（AOR，43.4；95% CI，4.4 - 434.1）、被爆炸气流冲击（AOR，5.3；95% CI，2.1 - 13.8）以及被困（AOR，3.1；95% CI，1.2 - 7.7）相关。
俄克拉何马爆炸事件中非致命伤的严重程度主要与结构和环境因素相关。改进建筑设计可能预防建筑物爆炸中的许多伤害。这些发现为未来的伤害预防活动提供了证据。
