背景:自2015年以来,也门一直经历着旷日持久的内战和人道主义危机,这导致了许多与战争有关的伤害。然而,缺乏流行病学数据,特点,以及这些伤害的结果,尤其是骨科的。本研究旨在描述也门与战争有关的骨科损伤及其对患者健康和功能的影响。
方法:这是一项回顾性研究,基于2015年1月至2020年12月在萨那市三个主要创伤中心因与战争有关的骨科损伤入院的3930名患者的医疗记录和创伤登记。我们收集了人口统计数据,损伤机制,损伤类型和位置,外科手术,并发症,死亡率,和功能结果使用肌肉骨骼功能评估问卷。我们使用描述性和推断性统计来分析数据,并进行逻辑回归分析以确定与死亡率相关的因素。
结果:大多数患者是年轻男性和平民,他们遭受了涉及多个身体区域的复杂和严重的伤害,尤其是下肢.伤害的主要机制是枪伤,爆炸伤,还有地雷爆炸.患者需要多种手术和植入物,并发症和死亡率高。最常见的并发症是感染,骨不连,malunion,和截肢。最常见的死亡原因是败血症。功能结果很差,如高平均MFA评分所示。Logistic回归分析显示,年龄较大,爆炸伤,脊柱损伤,血管损伤,和感染是死亡率的重要预测因子。
结论:本研究提供了也门与战争有关的骨科损伤及其对患者健康和功能影响的有价值的信息。它还确定了一些未来研究的领域,如探索感染和不愈合/畸形的危险因素,评估不同外科手术和植入物的有效性和成本效益,评估患者的长期结果和生活质量,并开发新的策略来增强骨骼和软组织的愈合。
BACKGROUND: Yemen has been experiencing a protracted civil war and humanitarian crisis since 2015, which has resulted in many war-related injuries. However, there is a lack of data on the epidemiology, characteristics, and outcomes of these injuries, especially the orthopedic ones. This study aimed to describe the war-related orthopedic injuries in Yemen and their impact on the patients\' health and function.
METHODS: This was a retrospective study based on medical records and trauma registries of 3930 patients who were admitted to three major trauma centers in Sana\'a city with war-related orthopedic injuries from January 2015 to December 2020. We collected data on demographics, injury mechanisms, injury types and locations, surgical procedures, complications, mortality, and functional outcomes using the Musculoskeletal Function Assessment questionnaire. We used descriptive and inferential statistics to analyze the data and performed a logistic regression analysis to identify the factors associated with mortality.
RESULTS: Most of the patients were young males and civilians who suffered from complex and severe injuries involving multiple body regions, especially the lower extremities. The main mechanisms of injury were gunshot wounds, blast injuries, and landmine explosions. The patients required multiple surgical procedures and implants, and had high rates of complications and mortality. The most common complications were infection, nonunion, malunion, and amputation. The most common cause of death was sepsis. The functional outcomes were poor, as indicated by the high mean MFA score. The logistic regression analysis showed that older age, blast injuries, spine injuries, vascular injuries, and infection were significant predictors of mortality.
CONCLUSIONS: This study provides valuable information on the war-related orthopedic injuries in Yemen and their impact on the patients\' health and function. It also identifies some areas for future research, such as exploring the risk factors for infection and nonunion/malunion, evaluating the effectiveness and cost-effectiveness of different surgical procedures and implants, assessing the long-term outcomes and quality of life of the patients, and developing novel strategies to enhance bone and soft-tissue healing.