الفهرس 
Introduction and rationale.Only 14 pages are availabe for public view
 |  | from | 115 |  |  |
| | | from | 115 | | |
Abstract
The study was conducted to evaluate the types, severity and outcome of blast injuries presented to emergency department in Suez Canal University Hospitals, during the period from July 2007 to July 2010, based on the clinical presentation, investigations and management.
The median age of the patients was 29 years. The frequency of males was higher than females (71.5% versus 28.5%, respectively). The most frequent occupation among patients was soldiers (29.9%). Gaza was the most affected region among the studied areas (59%).
The most frequent cause of injuries was bombs (41.7%), followed by rockets (31.9%), and the least frequent cause of injuries was gas explosion (5.6%). The prevalence of unknown cause of injuries was 11.8%. About 71% of the patients were recruited between the period of July 2008 and June 2009.
The most frequent injury sites were as followed (from higher to lower); fractures (UL, LL) (59.7%), abdominal trauma (53.5%), head trauma (43.1%), chest injury (31.3%) and burn (22.2%).
The most frequent types of management in abdominal trauma were as followed (from higher to lower); stomach and intestinal repair (41.6%), splenectomy (37.7%), liver repair (29.9%) and colostomy (19.5%).
The most frequent complications of abdominal trauma were as followed (from higher to lower); wound infection (36.4%), wound dehiscence (10.4%), intestinal fistula (7.8%) and secondary hemorrhage (6.5%). Six patients (7.8%) died in ER department.
The most frequent types of management in chest trauma were as followed (from higher to lower); chest tube insertion (86.7%), urgent thoracotomy 6 hrs (17.8%), lung repair (13.3%) and diaphragm repair (13.3%). The most frequent complications were as followed (from higher to lower); chest infection (42.2%), wound infection (15.6%) and arrest and intubated (13.3%). Four patients (8.9%) died in ER department.
The most frequent types of management in musculoskeletal trauma were as followed (from higher to lower); internal fixation (57.9%), primary amputation (24.6%), external fixation (20.2%) and K-wire insertion (18.4%). The most frequent complications were as followed (from higher to lower); wound infection (18.4%) and bone malunion (7.9%). Eight patients (7%) died in ER department.
The most frequent type of management in head and spinal trauma was craniotomy (41.6%) and the least frequent type of management was spine fixation (11.7%). The most frequent complications were as followed (from higher to lower); neurological insult (24.7%) and wound infection (16.9%). Eleven patients (14.3%) died in ER department.
The most frequent types of management in ocular trauma were as followed (from higher to lower); foreign body removal (41.7%), eyelid repair (33.3%) and evisceration (20.8%). The most frequent complication was diminished visual acuity (37.5%) and the least frequent complication was endophthalmitis (8.3%).
The most frequent types of management in auditory trauma were as followed (from higher to lower); external ear repair (42.1%) and foreign body removal (31.6%). The most frequent complication was decreased hearing acuity (31.6%) and the least frequent complication was loss of hearing (10.5%).
In early period (within first 24 hours), 20 patients died and 23 patients admitted to ICU, while during the late period (> 7 days till discharge) 6 patients died and 5 patients admitted to ICU.
The frequency of patients with ISS scores 0-<25 was 30.6%, with ISS scores 25-<50 was 50.7% and with ISS scores 50-75 was 18.7%. Patients with ISS scores 50-75 had significantly higher rate of death than patients with ISS scores 0-<25 and 25-<50 (42.1% versus 21.1% and 36.8%, respectively).
According to RTS, the frequency of patients with priority 1 (≤ 10) was 25.7%, with priority 2 (11) was 55.6% and with priority 3 (12) was 18.8%. Patients with priority 1 had significantly higher rate of death than patients with priority 2 and 3 (52.6% versus 39.5% and 7.9%, respectively).
The frequency of died patients with blunt trauma was