Leibovici D, Gofrit O N, Stein M, Shapira S C, Noga Y, Heruti R J, Shemer J
Department of Urology, Hadassah Medical Center, Jerusalem, Israel.
J Trauma. 1996 Dec;41(6):1030-5. doi: 10.1097/00005373-199612000-00015.
To compare injury patterns resulting from explosions in the open air versus within confined spaces.
Medical charts of 297 victims of four bombing events were analyzed. Two explosions occurred in the open air and two inside buses. Similar explosive devices were applied in all four incidents. The incidence of primary blast injuries, significant penetrating trauma (Abbreviated Injury Scale score > or = 2), burns, Injury Severity Score, Revised Trauma Score, and mortality were compared between the two populations.
A total of 204 casualties were involved in open-air bombings, 15 of whom died (7.8%). Ninety-three victims were involved in bus bombings, 46 of whom died (49%). The difference in mortality rate was highly significant, p < 0.00001. Primary blast injuries were observed in 25 and 31 victims (34.2% and 77.5% of admitted victims), respectively (p = 0.00003). Median Injury Severity Score was 4 versus 18, respectively (p < 0.0001).
Explosions in confined spaces are associated with a higher incidence of primary blast injuries, with more severe injuries and with a higher mortality rate in comparison with explosions in the open air.
比较露天爆炸与密闭空间爆炸所导致的损伤模式。
分析了四起爆炸事件中297名受害者的病历。其中两起爆炸发生在露天，两起发生在公交车内。所有四起事件均使用了类似的爆炸装置。比较了两组人群中原发性爆震伤、严重穿透伤（简明损伤定级标准评分≥2）、烧伤、损伤严重度评分、修正创伤评分及死亡率的发生率。
露天爆炸共造成204人伤亡，其中15人死亡（7.8%）。公交车爆炸造成93人伤亡，其中46人死亡（49%）。死亡率差异极为显著，p<0.00001。原发性爆震伤分别见于25名和31名受害者（占入院受害者的34.2%和77.5%）（p=0.00003）。损伤严重度评分中位数分别为4和18（p<0.0001）。
与露天爆炸相比，密闭空间爆炸导致原发性爆震伤的发生率更高，损伤更严重，死亡率也更高。
