War-related traumatic brain injuries during the Syrian armed confict in Damascus 2014–2017: a cohort study and a literature review
Dublin Core
Title
War-related traumatic brain injuries during the Syrian armed confict in Damascus 2014–2017: a cohort study and a literature review
Subject
Explosion injury, Gunshot injury, Neurological injury, Syrian armed confict, War-related injury, Combat
injury, Brain injury
injury, Brain injury
Description
Background The decade-long Syrian armed confict killed or injured more than 11% of the Syrian population. Head
and neck injuries are the most frequent cause of war-related trauma, about half of which are brain injuries. Reports
about Syrian brain trauma victims were published from neighboring countries; However, none are available from Syrian hospitals. This study aims to report war-related traumatic brain injuries from the Syrian capital.
Methods We conducted a retrospective cohort study between 2014 and 2017 at Damascus Hospital, the largest
public hospital in Damascus, Syria. Target patients were the victims of combat-related traumatic brain injuries who
arrived alive and were admitted to the neurosurgery department or to another department but followed by the
neurosurgery team. The collected data included the mechanism, type, and site of injury based on imaging fndings;
types of invasive interventions; intensive-care unit (ICU) admissions; as well as neurological status at admission and
discharge including several severity scales.
Results Our sample consisted of 195 patients; Ninety-six of them were male young adults, in addition to 40 females
and 61 children. Injuries were caused by shrapnel in 127 (65%) cases, and by gunshots in the rest, and most of them
(91%) were penetrating. Sixty-eight patients (35%) were admitted to the ICU, and 56 (29%) underwent surgery.
Neurological impairment was reported in 49 patients (25%) at discharge, and the mortality rate during hospitalization
was 33%. Mortality and neurological impairment associated signifcantly with higher values on clinical and imaging
severity scores.
Conclusions This study captured the full spectrum of war-related brain injuries of civilians and armed personnel in
Syria without the delay required to transport patients to neighboring countries. Although the clinical presentation
of injuries at admission was not as severe as that in previous reports, the inadequate resources (i.e., ventilators and
operation rooms) and the lack of previous experience with similar injuries might have resulted in the higher mortality
rate. Clinical and imaging severity scales can provide a handy tool in identifying cases with low probability of survival
especially with the shortage of personal and physical resources.
and neck injuries are the most frequent cause of war-related trauma, about half of which are brain injuries. Reports
about Syrian brain trauma victims were published from neighboring countries; However, none are available from Syrian hospitals. This study aims to report war-related traumatic brain injuries from the Syrian capital.
Methods We conducted a retrospective cohort study between 2014 and 2017 at Damascus Hospital, the largest
public hospital in Damascus, Syria. Target patients were the victims of combat-related traumatic brain injuries who
arrived alive and were admitted to the neurosurgery department or to another department but followed by the
neurosurgery team. The collected data included the mechanism, type, and site of injury based on imaging fndings;
types of invasive interventions; intensive-care unit (ICU) admissions; as well as neurological status at admission and
discharge including several severity scales.
Results Our sample consisted of 195 patients; Ninety-six of them were male young adults, in addition to 40 females
and 61 children. Injuries were caused by shrapnel in 127 (65%) cases, and by gunshots in the rest, and most of them
(91%) were penetrating. Sixty-eight patients (35%) were admitted to the ICU, and 56 (29%) underwent surgery.
Neurological impairment was reported in 49 patients (25%) at discharge, and the mortality rate during hospitalization
was 33%. Mortality and neurological impairment associated signifcantly with higher values on clinical and imaging
severity scores.
Conclusions This study captured the full spectrum of war-related brain injuries of civilians and armed personnel in
Syria without the delay required to transport patients to neighboring countries. Although the clinical presentation
of injuries at admission was not as severe as that in previous reports, the inadequate resources (i.e., ventilators and
operation rooms) and the lack of previous experience with similar injuries might have resulted in the higher mortality
rate. Clinical and imaging severity scales can provide a handy tool in identifying cases with low probability of survival
especially with the shortage of personal and physical resources.
Creator
Ibrahem Hanaf , Eskander Munder , Sulafa Ahmad , Iman Arabhamo , Suzan Alziab , Noor Badin , Ahmad Omarain , Mhd Khaled Jawish , Muhannad Saleh , Vera Nickl , Tamara Wipplinger , Christoph Wipplinger and Robert Nickl
Publisher
BMC Emergency Medicine
Date
(2023) 23:35
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Ibrahem Hanaf , Eskander Munder , Sulafa Ahmad , Iman Arabhamo , Suzan Alziab , Noor Badin , Ahmad Omarain , Mhd Khaled Jawish , Muhannad Saleh , Vera Nickl , Tamara Wipplinger , Christoph Wipplinger and Robert Nickl, “War-related traumatic brain injuries during the Syrian armed confict in Damascus 2014–2017: a cohort study and a literature review,” Repository Horizon University Indonesia, accessed November 14, 2024, https://repository.horizon.ac.id/items/show/4329.