Syria civil war pediatric casualties treated at a single medical center.

PURPOSE

We describe the medical and surgical treatment outcomes of Syrian civil war pediatric casualties admitted to our tertiary medical center in northern Israel and compare them to reports of pediatric war victims in Iraq and Afghanistan.

METHODS

117 pediatric casualties up to age 18 (median age: 12 years, 91 males) were admitted from 2013 to 2016. We measured demographics, injury mechanism, wound type, injury severity, surgical interventions, morbidity, and mortality.

RESULTS

Injury mechanisms were penetrating injuries (n = 87, 74%), blunt (n = 34, 29%) and blast (n = 13, 11%) injuries, caused by fragments (56, 48%), blasts (51, 44%), and gunshot wounds (24, 21%). Most common injuries were head trauma (n = 66, 56%) and lower extremities injury (n = 45, 38%). 51 children (44%) had Injury Severity Score > 25. Surgical procedures, most commonly orthopedic (n = 35) and neurosurgical (n = 27), were performed on 81 children (69%). Average number of procedures per patient was 2 ± 2.5; average hospitalization time was 25.8 days. Mortality rate was 3.4% (four children). Injury characteristics were different from those reported for pediatric war casualties in Iraq and Afghanistan.

CONCLUSIONS

Head trauma was associated with serious injury and mortality; most injuries were penetrating and complex. Collaboration of various hospital departments was often necessary for efficient and successful treatment.

LEVEL OF EVIDENCE III

Retrospective comparison study.