背景:枪声和炸弹爆炸是冲突地区四肢受伤的重要原因,然而,关于平民人群中这些伤害的特征和结果的研究很少。
方法:我们利用2015-2019年在约旦和伊拉克两家民用医院进行的随机试验数据进行了前瞻性队列分析。包括四肢受伤≤72小时的成年人。我们使用损伤机制(枪击/炸弹爆炸)作为第5天的暴露和伤口闭合作为主要结果指标。
结果:人口主要由年轻男性组成(n=163,94%男性,和中位数年龄29岁)因枪声(61%)或炸弹爆炸(39%)受伤。与枪击组相比,炸弹爆炸组的更多参与者同时受伤(32/63[51%]vs.11/100[11%],p<0.001)和血管损伤(9/63[14%]vs.4/100[4%],p=0.02)。与枪击组相比,炸弹爆炸组的伤口更大(中位面积86cm2[IQR24-161]与21cm2[IQR7-57],p<0.001)。与炸弹爆炸组相比,到第5天,枪弹组的参与者明显更多(74/100[74%]vs.16/63[25%],p<0.001)。在控制混杂因素后,这种差异仍然存在(比值比4.7,95%置信区间1.6-13.7)。
结论:在与冲突有关的四肢受伤的平民中,炸弹爆炸伤口在5天内实现闭合的可能性低于枪伤,独立于其他因素,如伤口大小和血管损伤。
背景:ClinicalTrials.gov,NCT02444598。注册14-05-2015,https://classic。
结果:gov/ct2/show/NCT02444598。
BACKGROUND: Gunshots and bomb blasts are important causes of extremity injuries in conflict zones, yet little research exists on the characteristics and outcomes of these injuries in civilian populations.
METHODS: We performed a prospective cohort analysis utilizing data from a randomized trial conducted at two civilian hospitals in Jordan and Iraq in 2015-2019. Adults who presented ≤72 h of sustaining an extremity injury were included. We used mechanism of injury (
gunshot/bomb blast) as the exposure and wound closure by day 5 as the primary outcome measure.
RESULTS: The population predominantly comprised young men (n = 163, 94% male, and median age 29 years) injured by gunshots (61%) or bomb blasts (39%). Compared with the
gunshot group, more participants in the bomb blast group had concomitant injuries (32/63 [51%] vs. 11/100 [11%], p < 0.001) and vascular injuries (9/63 [14%] vs. 4/100 [4%], p = 0.02). The wounds were larger in the bomb blast group compared with the
gunshot group (median area 86 cm2 [IQR 24-161] vs. 21 cm2 [IQR 7-57], p < 0.001). Compared with the bomb blast group, significantly more participants in the
gunshot group achieved wound closure by day 5 (74/100 [74%] vs. 16/63 [25%], p < 0.001). This difference remained after controlling for confounding factors (odds ratio 4.7, 95% confidence interval 1.6-13.7).
CONCLUSIONS: In civilians with conflict-related extremity injuries, bomb blast wounds had a lower likelihood of achieving closure within 5 days than
gunshot wounds, independent of other factors, such as wound size and vascular injuries.
BACKGROUND: ClinicalTrials.gov, NCT02444598. Registered 14-05-2015, https://classic.
RESULTS: gov/ct2/show/NCT02444598.