Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA.
Department of Emergency Medicine, Yale University, New Haven, CT, USA.
Neurol Sci. 2022 Jun;43(6):3769-3774. doi: 10.1007/s10072-022-05878-3. Epub 2022 Jan 12.
Despite nearly a decade of conflict, little is known about trauma and injuries resulting from the Syrian war.
Secondary analysis was conducted of an administrative dataset of patient presentations to a network of 95 war-affected hospitals in Syria from July 2013-July 2015. Logistic regression was performed to identify factors associated with mortality of neurotrauma patients.
Of 193,618 overall trauma presentations, 41,143 were for neurotrauma (37,410 head trauma, 1407 spinal trauma, and 3133 peripheral nervous system). There were 31,359 males (76.2%) and 9784 females (23.8%). Males aged 19-30 years (10,113; 24.6%) were the largest single demographic group. Presumed non-combatants including females, elders, and children under 13 years (16,214; 39.4%) were the largest group of patients overall. There were 16,881 (41.0%) presentations with blunt injuries (blunt/crush injuries) and 21,307 (51.8%) patients with penetrating injuries (shrapnel, cut, gunshot). A total of 36,589 patients (89.6%) were treated and discharged from the hospital, 2100 (5.1%) were transferred to another facility, 2050 patients (5.0%) died in-hospital, 26 remained in the hospital (0.1%), and 108 (0.3%) had unknown disposition. The median length of hospital stay was 1 day. There were 4034 (9.7%) neurosurgical procedures documented. Patients with combined neurotrauma and general trauma suffered 30 times higher mortality than neurotrauma alone (aOR: 30.4; 95% CI: 20.8-44.2, p < 0.0001).
The Syrian War resulted in large volumes of neurotrauma patients. Presumed non-combatants comprised 39.4% of patients who survived to treatment at a facility. Further study is needed on long-term needs of neurotrauma victims of the Syrian war.
尽管叙利亚战争已持续近十年，但对于战争造成的创伤和伤害知之甚少。
对 2013 年 7 月至 2015 年 7 月期间叙利亚 95 家受战争影响医院网络中收治的患者进行了一项基于行政病历的二次分析。采用 logistic 回归分析，以确定与神经创伤患者死亡率相关的因素。
在 193618 例总体创伤病例中，41143 例为神经创伤（37410 例颅脑损伤，1407 例脊柱损伤，3133 例周围神经系统损伤）。31359 例为男性（76.2%），9784 例为女性（23.8%）。19-30 岁的男性（10113 例，24.6%）是最大的单一人群。非战斗人员（包括女性、老年人和 13 岁以下儿童）是总体上最大的患者群体，共 16214 例（39.4%）。钝性伤（钝器/挤压伤）有 16881 例（41.0%），穿透伤（弹片伤、切割伤、枪伤）有 21307 例（51.8%）。36589 例患者（89.6%）接受治疗并从医院出院，2100 例（5.1%）转至其他医疗机构，2050 例（5.0%）在院内死亡，26 例仍在医院（0.1%），108 例（0.3%）去向不明。中位住院时间为 1 天。有 4034 例（9.7%）记录了神经外科手术。同时患有神经创伤和普通创伤的患者的死亡率比单纯神经创伤高 30 倍（调整比值比：30.4；95%置信区间：20.8-44.2，p<0.0001）。
叙利亚战争导致大量神经创伤患者。幸存至医疗机构治疗的患者中，假定非战斗人员占 39.4%。需要进一步研究叙利亚战争中神经创伤受害者的长期需求。
