Blast injuries: Bus versus open-air bombings - A comparative study of injuries in survivors of open-air versus confined-space explosions

Dan Leibovici, Ofer N. Gofrit*, Michael Stein, Shmuel C. Shapira, Yossi Noga, Rafael J. Heruti, Joshua Shemer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To compare injury patterns resulting from explosions in the open air versus within confined spaces. Methods: Medical charts of 297 victims of four bombing events were analyzed. Two explosions occurred in the open air and two inside buses. Similar explosive devices were applied in all four incidents. The incidence of primary blast injuries, significant penetrating trauma (Abbreviated Injury Scale score ≤ 2), burns, Injury Severity Score, Revised Trauma Score, and mortality were compared between the two populations. Results: A total of 204 casualties were involved in open- air bombings, 15 of whom died (7.8%). Ninety-three victims were involved in bus bombings, 46 of whom died (49%). The difference in mortality rate was highly significant, p < 0.00001. Primary blast injuries were observed in 25 and 31 victims (34.2% and 77.5% of admitted victims), respectively (p = 0.00003). Median Injury Severity Score was 4 versus 18, respectively (p < 0.0001). Conclusion: Explosions in confined spaces are associated with a higher incidence of primary blast injuries, with more severe injuries and with a higher mortality rate in comparison with explosions in the open air.

Original languageEnglish
Pages (from-to)1030-1035
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume41
Issue number6
DOIs
StatePublished - Dec 1996

Keywords

  • Bombings
  • Confined space
  • Explosions
  • Open air

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