Increased Mortality Rates of Young Children With Traumatic Injuries at a US Army Combat Support Hospital in Baghdad, Iraq, 2004

Abstract

Young children who present to a combat support hospital have increased severity of injury compared with older children and adults. In a population with primarily penetrating injuries, after adjustment for severity of injury, young children may also have an independent increased risk for death compared with older children and adults. Providing forward-deployed medical staff with pediatric-specific equipment and training in the acute care of young children with severe traumatic injuries may improve outcomes in this population.

Severe Pediatric Head Injury During the Iraq and Afghanistan Conflicts

“…The majority (76%) of children treated were male with a median age of 8 years (range 0. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Penetrating injuries were the most common type (60.6%), with the most common causes being IED (37.9%) or blast (25%).…”

“…For descriptive purposes, patients in the entire cohort were further divided into the following age groups: infant (0-1 year), toddler (2-3), child (4-9), preteen (10)(11)(12), and adolescent (13)(14)(15)(16)(17). Data from the JTTR classified injury types into open, penetrating, and closed categories.…”

“…Many authors have documented their experience treating children injured during these campaigns. 1,[6][7][8][9][10][11][12][13][14] We and others have detailed our experience treating children with neurosurgical injuries and diseases during these 2 conflicts, typically over a finite time period. [15][16][17] This project was undertaken to describe the epidemiologic features and outcomes associated with isolated severe head injury in children treated at military medical facilities during OIF and OEF with the use of the Joint Theater Trauma Registry (JTTR).…”

Transfusion sanguine en opération extérieure. Expérience à l’hôpital médico-chirurgical de Kaboul

“…La France n'est pas la seule force de la coalition à pratiquer l'aide mé dicale à la population. En effet, diffé rentes é tudes amé ricaines retrouvent qu'environ 30 à 40 % des admissions et que 60 % des journé es d'hospitalisation inté ressent des civils (Afghans ou Irakiens) [11][12][13], ce qui repré sente jusqu'à 4983 patients non combattants (dont 25 % de pé diatrie) admis dans les structures amé ricaines en Afghanistan et en Irak de 2002 à 2010 [14]. Une é tude canadienne montre que 44 % de l'activité d'un de ses rôles 3 concerne des civils Afghans avec un âge moyen de 25 ans et 16 % de pé diatrie [15].…”

“…Au total, 377 CGR provenant de France (acheminé s par le CTSA) ont é té transfusé s ainsi que 167 poches de ST pré levé s sur place. Le taux mé dian d'hé moglobine avant une transfusion é tait de 8,1 g/dL(3,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Soixante-et-onze pour cent des patients (n = 90) ont é té transfusé s dans les 24 heures.…”