Syria civil war pediatric casualties treated at a single medical center

Oriyan Naaman; Alon Yulevich; Yechiel Sweed

doi:10.1016/j.jpedsurg.2019.02.022

Syria civil war pediatric casualties treated at a single medical center

Oriyan Naaman, Alon Yulevich, Yechiel Sweed

Bar-Ilan University - Azrieli Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Purpose: We describe the medical and surgical treatment outcomes of Syrian civil war pediatric casualties admitted to our tertiary medical center in northern Israel and compare them to reports of pediatric war victims in Iraq and Afghanistan. Methods: 117 pediatric casualties up to age 18 (median age: 12 years, 91 males) were admitted from 2013 to 2016. We measured demographics, injury mechanism, wound type, injury severity, surgical interventions, morbidity, and mortality. Results: Injury mechanisms were penetrating injuries (n = 87, 74%), blunt (n = 34, 29%) and blast (n = 13, 11%) injuries, caused by fragments (56, 48%), blasts (51, 44%), and gunshot wounds (24, 21%). Most common injuries were head trauma (n = 66, 56%) and lower extremities injury (n = 45, 38%). 51 children (44%) had Injury Severity Score > 25. Surgical procedures, most commonly orthopedic (n = 35) and neurosurgical (n = 27), were performed on 81 children (69%). Average number of procedures per patient was 2 ± 2.5; average hospitalization time was 25.8 days. Mortality rate was 3.4% (four children). Injury characteristics were different from those reported for pediatric war casualties in Iraq and Afghanistan. Conclusions: Head trauma was associated with serious injury and mortality; most injuries were penetrating and complex. Collaboration of various hospital departments was often necessary for efficient and successful treatment. Level of evidence III: Retrospective comparison study.

Original language	English
Pages (from-to)	523-529
Number of pages	7
Journal	Journal of Pediatric Surgery
Volume	55
Issue number	3
DOIs	https://doi.org/10.1016/j.jpedsurg.2019.02.022
State	Published - Mar 2020

Bibliographical note

Funding Information:
Caring for thousands of seriously wounded adults and children from the Syrian civil war has profoundly changed our hospital, Galilee Medical Center. We would like to thank all those who have taken part in this monumental effort, from the director of our medical center, Dr. Masad Barhoum, to the doctors and nurses, social workers and therapists, but especially to the following:, Dr. Michael Weiss, Dr. Eli Kakiashvili, Prof. Aryeh Eitan – Department of Surgery A. Dr. Igor Waxman – Department of Surgery B. Prof. Jean Soustiel and Dr. Samuel Tobias – Department of Neurosurgery. Dr. Haim Shtarker and Dr. Michael Ass'af – Department of Orthopedics A. Dr. Tatyana Arzumanov – Department of Anesthesiology. Dr. Leonid Kogan – Department of Plastic and Reconstructive Surgery. Dr. Zeev Zonis – Pediatric Intensive Care. Prof. Daniel Glikman – Infectious Diseases Unit.

Publisher Copyright:
© 2019 Elsevier Inc.

Keywords

Casualties
Civil war
Pediatric surgery
Pediatric trauma
Pediatric wartime trauma
Syrian children

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10.1016/j.jpedsurg.2019.02.022

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abstract = "Purpose: We describe the medical and surgical treatment outcomes of Syrian civil war pediatric casualties admitted to our tertiary medical center in northern Israel and compare them to reports of pediatric war victims in Iraq and Afghanistan. Methods: 117 pediatric casualties up to age 18 (median age: 12 years, 91 males) were admitted from 2013 to 2016. We measured demographics, injury mechanism, wound type, injury severity, surgical interventions, morbidity, and mortality. Results: Injury mechanisms were penetrating injuries (n = 87, 74%), blunt (n = 34, 29%) and blast (n = 13, 11%) injuries, caused by fragments (56, 48%), blasts (51, 44%), and gunshot wounds (24, 21%). Most common injuries were head trauma (n = 66, 56%) and lower extremities injury (n = 45, 38%). 51 children (44%) had Injury Severity Score > 25. Surgical procedures, most commonly orthopedic (n = 35) and neurosurgical (n = 27), were performed on 81 children (69%). Average number of procedures per patient was 2 ± 2.5; average hospitalization time was 25.8 days. Mortality rate was 3.4% (four children). Injury characteristics were different from those reported for pediatric war casualties in Iraq and Afghanistan. Conclusions: Head trauma was associated with serious injury and mortality; most injuries were penetrating and complex. Collaboration of various hospital departments was often necessary for efficient and successful treatment. Level of evidence III: Retrospective comparison study.",

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Syria civil war pediatric casualties treated at a single medical center

Abstract

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Keywords

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