The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan 02149, Israel.
Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem 91120, Israel.
Mil Med. 2023 Jul 22;188(7-8):e1788-e1794. doi: 10.1093/milmed/usac280.
The incidence of blast injuries on the battlefield has risen over the last several decades. In order to improve prevention and treatment, it is essential to understand the severity and bodily distribution of these injuries. This study aims to characterize blast injury patterns among IDF fatalities.
This is a descriptive, retrospective study on postmortem reports of military-blast fatalities between the years 1982 and 2021. Body regions injured according to the Abbreviated Injury Scale (AIS) were described. The frequency of body region injury combinations was mapped, and the correlation between injured body regions was calculated using Pearson's coefficient. Analysis of a subgroup with a postmortem computed tomography (CT-PM) or autopsy was performed, describing severe (AIS ≥ 3) injury patterns.
Overall, 222 fatalities suffered from blast injury, with most injuries affecting the upper and lower extremities (63.7% and 66.5%, respectively), followed by the head (57.1%) and the thorax (56.6%). The median number of injured body regions was 4 (interquartile range, 2-5). The most frequent injury combinations were the upper and lower extremities (51%), the upper extremities and the thorax (45%), and the lower extremities and the thorax (41%). In all, 47/222 (21.2%) fatalities had a documented autopsy or CT-PM report. Among the fatalities with CT-PM or autopsy, the head (63.8%) and the thorax (57.4%) were most frequently severely injured (AIS ≥ 3).
Among blast fatalities in the military setting, the extremities were most commonly injured. However, data suggest that the head and thorax are more likely to sustain severe blast injuries resulting in mortality. Blast injuries in this cohort were characterized by concomitant involvement of several regions. Development of protective gear to minimize the multisystem injuries inflicted by blast injuries is warranted and should be focused on distinct types and anatomical distribution of severe blast injuries as reported in this study.
Level III, Retrospective analysis.
在过去几十年中，战场上爆炸伤的发生率有所上升。为了改善预防和治疗效果，了解这些伤害的严重程度和身体分布至关重要。本研究旨在描述以色列国防军（IDF）死亡人员中的爆炸伤模式。
这是一项关于 1982 年至 2021 年期间军事爆炸死亡人员的尸检报告的描述性、回顾性研究。根据损伤严重程度评分（AIS）描述受伤的身体部位。绘制了身体区域损伤组合的频率图，并使用 Pearson 系数计算了受伤身体区域之间的相关性。对具有尸体计算机断层扫描（CT-PM）或尸检的亚组进行了分析，描述了严重（AIS≥3）的损伤模式。
共有 222 名因爆炸伤死亡的人员，其中大多数受伤部位是上肢（63.7%）和下肢（66.5%），其次是头部（57.1%）和胸部（56.6%）。损伤的中位数为 4 个身体区域（四分位距，2-5）。最常见的损伤组合是上肢和下肢（51%）、上肢和胸部（45%）以及下肢和胸部（41%）。共有 47/222（21.2%）名死亡人员有尸检或 CT-PM 报告。在有 CT-PM 或尸检的死亡人员中，头部（63.8%）和胸部（57.4%）最常受到严重（AIS≥3）爆炸伤。
在军事环境中的爆炸伤死亡人员中，四肢最常受伤。然而，数据表明头部和胸部更有可能因严重的爆炸伤而导致死亡。该队列中的爆炸伤特点是几个部位同时受累。为了减轻爆炸伤造成的多系统损伤，有必要开发保护装备，并且应该针对本研究报告的这种严重爆炸伤的特定类型和解剖分布进行重点开发。
三级，回顾性分析。
