The dynamics of prehospital/hospital care and modes of transport during civil conflict and terrorist incidents

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dc.contributor.authorCelik, S.
dc.contributor.authorDursun, R.
dc.contributor.authorAycan, A.
dc.contributor.authorGonullu, H.
dc.contributor.authorAdanas, C.
dc.contributor.authorEryilmaz, M.
dc.contributor.authorGonullu, E.
dc.date.accessioned2024-04-24T16:18:18Z
dc.date.available2024-04-24T16:18:18Z
dc.date.issued2017
dc.departmentDicle Üniversitesien_US
dc.description.abstractObjective: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. Study design: Multicentric prospective observational study. Method: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. Results: The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044-1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639-0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. Conclusions: Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.en_US
dc.identifier.doi10.1016/j.puhe.2017.07.029
dc.identifier.endpage116en_US
dc.identifier.issn0033-3506
dc.identifier.issn1476-5616
dc.identifier.pmid28886492
dc.identifier.scopus2-s2.0-85033411027
dc.identifier.scopusqualityQ1
dc.identifier.startpage108en_US
dc.identifier.urihttps://doi.org/10.1016/j.puhe.2017.07.029
dc.identifier.urihttps://hdl.handle.net/11468/15982
dc.identifier.volume152en_US
dc.identifier.wosWOS:000413409400017
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherW B Saunders Co Ltden_US
dc.relation.ispartofPublic Health
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectTerrorist Incidentsen_US
dc.subjectPrehospital Careen_US
dc.subjectMode Of Transportationen_US
dc.titleThe dynamics of prehospital/hospital care and modes of transport during civil conflict and terrorist incidentsen_US
dc.titleThe dynamics of prehospital/hospital care and modes of transport during civil conflict and terrorist incidents
dc.typeArticleen_US

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