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Mass casualty terrorist bombings: A comparison of outcomes by bombing type

โœ Scribed by Jeffrey L Arnold; Pinchas Halpern; Ming-Che Tsai; Howard Smithline


Book ID
104310048
Publisher
Elsevier Science
Year
2004
Tongue
English
Weight
169 KB
Volume
43
Category
Article
ISSN
1097-6760

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โœฆ Synopsis


Study objective: We compared the epidemiologic outcomes of terrorist bombings that produced 30 or more casualties and resulted in immediate structural collapse, occurred within a confined space, or occurred in open air.

Methods:

We identified eligible studies of bombings through a MEDLINE search of articles published between 1966 and August 2002 and a manual search of published references. Pooled and median rates of mortality, immediately injured survival, emergency department use, hospitalization, and injury were determined for each bombing type.

Results: We found 35 eligible articles describing 29 terrorist bombings, collectively producing 8,364 casualties, 903 immediate deaths, and 7,461 immediately surviving injured. Pooled immediate mortality rates were structural collapse 25% (95% confidence interval [CI] 6% to 44%), confined space 8% (95% CI 1% to 14%), and open air 4% (95% CI 0% to 9%). Biphasic distributions of mortality were identified in all bombing types. Pooled hospitalization rates were structural collapse 25% (95% CI 6% to 44%), confined space 36% (95% CI 27% to 46%), and open air 15% (95% CI 5% to 26%). Unique patterns of injury rates were found in all bombing types.

Conclusion:

Patterns of injury and health care system use vary with the type of terrorist bombing.