Open AccessEpidemiology of Trauma Patients from the Mosul Offensive, 2016–2017: Results from a Dedicated Trauma Center in Erbil, Iraqi Kurdistan
Author(s) -
Nerlander Maximilian P.,
Haweizy Rawand Musheer,
Wahab Moayad Abdullah,
Älgå Andreas,
Schreeb Johan
Publication year - 2018
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-018-4817-1
Subject(s) - epidemiology , medicine , offensive , trauma center , medical emergency , mortality rate , preparedness , retrospective cohort study , emergency medicine , surgery , political science , law , management , economics
Most epidemiological studies from conflicts are restricted to either combatants or civilians. It is largely unknown how the epidemiology differs between the two groups. In 2016, an Iraqi‐led coalition began retaking Mosul from the terrorist group Islamic State of Iraq and Syria. One key institution that received trauma patients from Mosul was Emergency Management Center (EMC) in Erbil, 90 km away. The aim of this study was to describe the epidemiology, morbidity, and mortality of civilians and combatants admitted during the ongoing conflict. Method This retrospective cohort study utilized routinely collected data on patients with conflict‐related injuries who were admitted to EMC between October 16, 2016, and July 10, 2017. Data processing and analysis was carried out using JMP 13. Categorical variables were compared using Fisher’s exact test. Results The analysis included 1725 patients, out of which 46% were civilian. Ordnance accounted for most injuries (68%), followed by firearms (18%) and improvised explosive devices (IEDs) (14%). The proportion of IED‐related injuries among combatants were almost three times that of civilians. The proportions of abdominal injuries, need for surgery, laparotomies, and amputations were significantly higher among civilians than among combatants. The mortality rate was 0.5%. Discussion The fact that civilians had greater surgical needs than combatants may be explained by several factors including a lack of ballistic protection. The extremely low mortality rate indicates significant gaps in prehospital care and transport. Our results may provide useful information to guide medical preparedness and response during future conflicts. Clinicaltrials.gov ID NCT03358758.