当车辆成为武器：以色列的故意车辆袭击事件
When a vehicle becomes a weapon: intentional vehicular assaults in Israel.
作者信息
Almogy Gidon, Kedar Asaf, Bala Miklosh
机构信息
Department of Surgery and Trauma Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
出版信息
Scand J Trauma Resusc Emerg Med. 2016 Dec 28;24(1):149. doi: 10.1186/s13049-016-0338-9.
BACKGROUND
We have recently witnessed an epidemic of intentional vehicular assaults (IVA) aimed at pedestrians. We hypothesized that IVA are associated with a specific injury pattern and severity.
METHODS
Retrospective analysis of prospectively acquired data of patients injured following IVA from October 2008 to May 2016 who were admitted to the Hadassah Level I trauma center in Jerusalem, Israel. Comparison of injury parameters and outcome caused by vehicular attacks to non-intentional pedestrian trauma (PT). Measured outcomes included ISS, AIS, injury pattern, ICU and blood requirements, participating teams, length of stay, and mortality.
RESULTS
There were 26 patients in the IVA group. Mean age in the IVA group was significantly younger and there were more males compared to the PT group (24.7 ± 13.3 years vs. 48.3 ± 21.3, and 81% vs. 52%, respectively, p < 0.01). Lower extremity (77% of patients), followed by head (58%) and facial (54%) injuries were most commonly injured in the IVA group, and this was significantly different from the pattern of injury in the PT group (54, 35, and 28%, respectively, p < 0.05). Mean ISS and median head AIS were significantly higher in the IVA group compared with the PT group (23.2 ± 12.8 vs. 15.4 ± 13.8, p = 0.012, and 4.5 vs. 3, p = 0.003, respectively). ICU admission and blood requirement were significantly higher in the IVA group (69% vs. 38%, and 50% vs. 19%, p < 0.01). Mortality was significantly higher in the IVA group (4 patients, 15%, vs. 3 patients, 4%, respectively, p = 0.036) and was caused by severe head trauma in all cases.
DISCUSSION
The severity of injury and mortality rate following IVA are higher compared with pedestrian injury. The pattern of injury following IVA is significantly different from non-intentional pedestrian trauma.
CONCLUSIONS
IVA results in higher mortality than conventional pedestrian trauma secondary to more severe head injury. More hospital resources are required following IVA than following conventional road traffic accidents.
背景
我们最近目睹了针对行人的故意车辆冲撞（IVA）事件的激增。我们假设IVA与特定的损伤模式和严重程度相关。
方法
对2008年10月至2016年5月在以色列耶路撒冷哈达萨一级创伤中心收治的因IVA受伤患者的前瞻性收集数据进行回顾性分析。将车辆袭击导致的损伤参数和结果与非故意行人创伤（PT）进行比较。测量的结果包括损伤严重度评分（ISS）、简明损伤定级（AIS）、损伤模式、重症监护病房（ICU）需求和输血需求、参与的团队、住院时间和死亡率。
结果
IVA组有26例患者。IVA组的平均年龄显著更年轻，男性比例也高于PT组（分别为24.7±13.3岁对48.3±21.3岁，以及81%对52%，p<0.01）。IVA组中最常见的损伤是下肢（77%的患者），其次是头部（58%）和面部（54%）损伤，这与PT组的损伤模式有显著差异（分别为54%、35%和28%，p<0.05）。与PT组相比，IVA组的平均ISS和头部AIS中位数显著更高（分别为23.2±12.8对15.4±13.8，p=0.012，以及4.5对3，p=0.003）。IVA组的ICU入院率和输血需求显著更高（分别为69%对38%，以及50%对19%，p<0.01）。IVA组的死亡率显著更高（分别为4例患者，15%，对3例患者，4%），所有死亡病例均由严重头部创伤导致。
讨论
与行人损伤相比，IVA后的损伤严重程度和死亡率更高。IVA后的损伤模式与非故意行人创伤有显著差异。
结论
由于更严重的头部损伤，IVA导致的死亡率高于传统行人创伤。与传统道路交通事故相比，IVA后需要更多的医院资源。
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