恐怖主义相关伤害与道路交通伤害相关创伤：以色列 5 年经验。
Terrorism-related injuries versus road traffic accident-related trauma: 5 years of experience in Israel.
机构信息
Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer 52621, Israel.
出版信息
Disaster Med Public Health Prep. 2009 Dec;3(4):196-200. doi: 10.1097/DMP.0b013e3181c12734.
BACKGROUND
Terrorism victims comprise the minority among trauma injured people, but this small population imposes a burden on the health care system. Thirty percent of the population injured in terrorist activities experienced severe trauma (injury severity score > or =16), more than half of them need a surgical procedure, and 25% of the population affected by terrorism had been admitted to intensive care. Furthermore, compared with patients with non-terrorism-related trauma, victims of terrorism often arrive in bulk, as part of a mass casualty event. This poses a sudden load on hospital resources and requires special organization and preparedness. The present study compared terrorism-related and road accident-related injuries and examined clinical characteristics of both groups of patients.
METHODS
This study is a retrospective study of all patients injured through terrorist acts and road traffic accidents from September 29, 2000 to December 31, 2005, and recorded in the Israel Trauma Registry. Data on the nature of injuries, treatment, and outcome were obtained from the registry. Medical diagnoses were extracted from the registry and classified based on International Classification of Diseases coding. Diagnoses were grouped to body regions, based on the Barell Injury Diagnosis Matrix.
RESULTS
The study includes 2197 patients with terrorism-related injuries and 30,176 patients injured in road traffic accidents. All in all, 27% of terrorism-related casualties suffered severe to critical injuries, comparing to 17% among road traffic accident-related victims. Glasgow Coma Scale scores </=8, measured in the emergency department, were among 12.3% of terrorism victims, in contrast with 7.4% among people injured on the roads. The terrorism victims had a significantly higher rate of use of intensive care facilities (24.2% vs 12.4%). The overall inpatient death rate was 6.0% among terrorism victims and 2.4% among those injured in road traffic accidents.
CONCLUSIONS
Casualties from terrorist events are more severely injured and require more resources relative to casualties from road traffic accidents.
背景
恐怖主义受害者在创伤受伤人群中占少数，但这一小部分人群给医疗保健系统带来了负担。在恐怖主义活动中受伤的人群中有 30%经历了严重创伤（损伤严重程度评分≥16），超过一半的人需要手术，受恐怖主义影响的人群中有 25%曾入住重症监护病房。此外，与非恐怖主义相关创伤患者相比，恐怖主义受害者通常作为大规模伤亡事件的一部分大量涌入。这对医院资源造成了突然的负担，需要特殊的组织和准备。本研究比较了与恐怖主义相关的伤害和与道路交通伤害，并检查了两组患者的临床特征。
方法
这是一项回顾性研究，研究对象为 2000 年 9 月 29 日至 2005 年 12 月 31 日期间因恐怖主义行为和道路交通伤害而受伤并记录在以色列创伤登记册中的所有患者。从登记册中获取有关受伤性质、治疗和结果的数据。从登记册中提取医学诊断，并根据国际疾病分类编码进行分类。根据巴雷尔损伤诊断矩阵将诊断分组到身体区域。
结果
本研究包括 2197 名与恐怖主义相关的受伤患者和 30176 名因道路交通伤害而受伤的患者。总体而言，27%的恐怖主义相关伤亡人员遭受严重至危急伤，而道路交通伤害相关伤亡人员中这一比例为 17%。在急诊科测量的格拉斯哥昏迷评分≤8 的患者中，12.3%是恐怖主义受害者，而道路交通伤害患者中这一比例为 7.4%。恐怖主义受害者使用重症监护设施的比例明显更高（24.2%比 12.4%）。恐怖主义受害者的住院总死亡率为 6.0%，而道路交通伤害患者为 2.4%。
结论
与道路交通伤害相比，恐怖主义事件的伤亡人员受伤更严重，需要更多的资源。
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