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The Impact of Age upon Contingency Planning for Multiple-casualty Incidents Based on a Single Center’s Experience

Published online by Cambridge University Press:  17 August 2016

Itamar Ashkenazi ,
Sharon Einav ,
Oded Olsha ,
Fernando Turegano-Fuentes ,
Michael M. Krausz  and
Ricardo Alfici
Itamar Ashkenazi*
Affiliation:
Hillel Yaffe Medical Centre, Hadera, Israel
Sharon Einav
Affiliation:
Shaare Zedek Medical Centre, Jerusalem, Israel
Oded Olsha
Affiliation:
Shaare Zedek Medical Centre, Jerusalem, Israel
Fernando Turegano-Fuentes
Affiliation:
Hospital General Universitario Gregorio Marañon, Madrid, Spain
Michael M. Krausz
Affiliation:
Hillel Yaffe Medical Centre, Hadera, Israel
Ricardo Alfici
Affiliation:
Hillel Yaffe Medical Centre, Hadera, Israel
*
Correspondence: Itamar Ashkenazi, MD Surgery Department Hillel Yaffe Medical Center POB 169, Hadera, Israel 38100 E-mail: i_ashkenazi@yahoo.com
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Abstract

Introduction

Trauma patients in the extremes of age may require a specialized approach during a multiple-casualty incident (MCI).

Problem

The aim of this study was to examine the type of injuries encountered in children and elderly patients and the implications of these injuries for treatment and organization.

Methods

A review of medical record files of patients admitted in MCIs in one Level II trauma center was conducted. Patients were classified according to age: children (≤12 years), adults (between 12-65 years), and elders (≥65 years).

Results

The files of 534 were screened: 31 (5.8%) children and 54 (10.1%) elderly patients. One-third of the elderly patients were either moderately or severely injured, compared to only 6.5% of the children and 11.1% of the adults (P<.001). Elderly patients required more blood transfusions (P=.0001), more computed tomography imaging (P=.0001), and underwent more surgery (P=.0004). Elders were hospitalized longer (P=.0003). There was no mortality among injured children, compared to nine (2.0%) of the adults and seven (13.0%) of the elderly patients (P<.0001). All the adult deaths occurred early and directly related to their injuries, whereas most of the deaths among the elderly patients (four out of seven) occurred late and were due to complications and multiple organ failure.

Conclusions

Injury at an older age confers an increased risk of complications and death in victims of MCIs.

AshkenaziI, EinavS, OlshaO, Turegano-FuentesF, KrauszMM, AlficiR. The Impact of Age upon Contingency Planning for Multiple-casualty Incidents Based on a Single Center’s Experience. Prehosp Disaster Med. 2016;31(5):492–497.

Keywords

blast injuriesemergency preparednessmultiple-casualty incidentsterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 5 , October 2016 , pp. 492 - 497
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Institute for Economics and Peace. 2012 Global Terrorism Index: capturing the impact of terrorism for the last decade. http://economicsandpeace.org/wp-content/uploads/2011/09/2012-Global-Terrorism-Index-Report.pdf. Accessed April 10, 2015.Google Scholar
2. Peleg, K, Aharonson-Daniel, L, Stein, M, et al. Gunshot and explosion injuries: characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004;239(3):311-318.Google Scholar
3. Ashkenazi, I, Kessel, B, Olsha, O, et al. Defining the problem, main objective, and strategies of medical management in mass-casualty incidents caused by terrorist events. Prehosp Disaster Med. 2008;23(1):82-89.CrossRefGoogle ScholarPubMed
4. Gennarelli, TA, Wodzin, E, (eds). The Abbreviated Injury Scale 2005. Barrington, Illinois USA: Association for the Advancement of Automotive Medicine; 2005.Google Scholar
5. Baker, SP, O’Neill, B, Haddon, W Jr, Long, WB. The injury severity score: a method for describing patients with multiple injuries and evaluation emergency care. J Trauma. 1974;14(3):187-196.Google Scholar
6. Central Bureau of Statistics, Israeli Government. Population, by population group, religion, sex and age. http://www.cbs.gov.il/archive/shnaton51/st02_18a.pdf. Accessed November 24, 2014.Google Scholar
7. Boyd, CR, Tolson, MA, Copes, WS. Evaluating trauma care: the TRISS method. J Trauma. 1987;27(4):370-378.Google Scholar
8. Cayten, CG, Stahl, WM, Agarwal, N, Murphy, JG. Analyses of preventable deaths by mechanism of injury among 13,500 trauma admissions. Ann Surg. 1991;214(4):510-520.Google Scholar
9. Aharonson-Daniel, L, Waisman, Y, Dannon, YL, Peleg, K, Israeli Trauma Group. Epidemiology of terror-related versus non-terror-related traumatic injury in children. Pediatrics. 2003;112(4):e280.Google Scholar
10. Jaffe, DH, Peleg, K, Israeli Trauma Group. Terror explosive injuries: a comparison of children, adolescents and adults. Ann Surg. 2010;25(1):138-143.Google Scholar
11. Corrigan, PW. Understanding Breivik and Sandy Hook: sin and sickness? World Psychiatry. 2013;12(2):174-175.Google Scholar
12. Champion, HR, Copes, WS, Buyer, D, Flanagan, ME, Bain, L, Sacco, WJ. Major trauma in geriatric patients. Am J Public Health. 1989;79(9):1278-1282.Google Scholar
13. Smith, DP, Enderson, BL, Maull, KI. Trauma in the elderly: determinants of outcome. South Med J. 1990;83(2):171-177.Google Scholar
14. Kuhne, CA, Ruchholtz, S, Kaiser, GM, Nast-Kolb, D. Mortality in severely injured elderly trauma patients – when does age become a risk factor? World J Surg. 2005;29(11):1476-1482.CrossRefGoogle ScholarPubMed
15. Taylor, MD, Tracy, JK, Meyer, W, Pasquale, M, Napolitano, LM. Trauma in the elderly: intensive care unit resource use and outcome. J Trauma. 2002;53(3):407-414.Google Scholar
16. Frohlich, M, Lefering, R, Probst, C, et al. Epidemiology and risk factors of multiple-organ failure after major trauma: an analysis of 31,154 patients from the Trauma Registry DGU. J Trauma Acute Care Surg. 2014;76(4):921-928.Google Scholar