Thoracoabdominal injuries after a bomb explosion: blast injuries and their clinical effects
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ORIGINAL ARTICLE
Thoracoabdominal injuries after a bomb explosion: blast injuries and their clinical effects Sadettin Er1 · Mehmet Tahtabasi2 Received: 28 April 2020 / Accepted: 30 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To report the types and effects of injuries to the thoracoabdominal region caused by blast and emphasize the importance of the early detection of primary blast injuries. Methods Of the 98 patients injured as a result of a bomb explosion, 31 with thoracoabdominal injuries were included in the study. The demographic and laboratory data, operations performed, and radiological findings were obtained from the electronic records of the patients. The injuries caused by the explosion were divided into four categories as primary, secondary, tertiary, and quaternary. The patients with a new injury severity score (NISS) of ≥ 16 were considered to have critical injuries. Results While mortality developed in 16 (51.6%) of 31 patients included in the study, 15 (48.4%) were discharged after treatment. The mean ages of the patients in the mortality and survivor groups were 29.6 ± 4.5 and 31.1 ± 10.7 years, respectively (p > 0.005). When the two groups were examined, the rate of hypovolemic shock and NISS score were significantly higher in the mortality group (p = 0.001 and p 0.05 was considered to indicate normally distributed data. Continuous variables that showed normal distribution were compared using Student’s t test, whereas the Mann–Whitney U test was used for non-normally distributed samples. The statistical significance level was accepted as p 0.005). The mean ages of the patients in the mortality and survivor groups were 29.6 ± 4.5 and 31.1 ± 10.7 years, respectively (p > 0.005). In the mortality group, the mean time to death was 5.2 ± 3.2 days. When the two groups were examined, although the number of injuries were similar, the rates of thoracoabdominal injuries, hypovolemic shock and
Discharged (n = 15)
operations performed were higher, especially in the mortality group. The rate of hypovolemic shock was statistically significantly higher in the mortality group (81.3 vs. 20.0%, p = 0.001). Concerning the type of injury, primary and secondary blast injuries were proportionally higher in the mortality group compared to the survivor group; however, there was no statistically significant difference between the two groups (p > 0.05). In addition, 61.3% (n = 19) of all patients had mixed- type (primary, secondary and/or tertiary) combined injuries, and the mixed type injury rate was higher in the mortality group compared to the survivor group (81.3 vs. 40.0%, p = 0.02). NISS was approximately two times higher in the mortality group compared to the survivor group (34.6 ± 12.5 vs 16.2 ± 7.2, p 0.005), according to the blood gas analysis at the time of presentation, the pH value was more acidic in the mortality group (7.18 ± 0.13) compared to the survivor group (7.34 ± 0.13) (p = 0.002). Similarly, the hemoglobin value at presentation was measured
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