Single center experience of war-related thoracic injury in Syria

Abstract

Background: The Syrian civil war caused serious deaths and injuries. Thoracic surgery has shown its effectiveness in this war as it is a war surgery. In this study, we analyzed war related chest trauma patients to describe the profile of chest trauma, determine the predictors’ morbidity and mortality. Methods: From 2012 to 2017, 47 consecutive patients underwent surgical treatment for chest trauma at the Gaziantep University Sahinbey Research and Practice Hospital, in Turkey. The demographic and relevant clinical information were retrospectively collected from the hospital records. Data included mechanism of injury, gender, and age, findings, treatment modality complications, and length of hospital stay, morbidity and mortality. Injuries were classified as penetrating (gunshot or shrapnel wounds) and blunt injuries. Results: The average age of patients was 25.4 years (range, 4 to 43 years) and 40 patients were males (85%). Sadly, 6 patients were under 18 years old. There were 41 patients (%87,2) penetrating and 6 patients (%12,8) blunt injuries. The most penetrating injuries of the chest were caused by shrapnel (61,7%). Eleven patients had already had emergency thoracotomy in another hospital before admission. As multiple diagnoses, there were 50 (45,45%) pneumothorax, hemothorax, or both in patients. However, there were 26 (23,64%) lung contusions in patients. No surgery-related deaths or major morbidity occurred. One patient died 35 days after admission; the causes of death in this patient included bronchobiliary fistula, hypovolemic shock, and sepsis. So, all cases mortality rate was 2,13%. Conclusion : Intervention in thoracic trauma patients is life-saving and satisfying compared to other system injuries. War surgery is a multidisciplinary approach, which is vital.