Thoracic Injuries during the War in Afghanistan: Analysis of the French Registry Reports

Seance of wednesday 24 june 2015 (Séance commune avec le Service de Santé des Armées à l'Ecole du Val-de-Grâce)

Abstract

Background: During Global War on Terror, 10% of casualties was presenting with chest trauma.Methods: The Combat Support Hospital of the Kabul International Airport is like a level 1 US trauma center and was used as a Role 3 in NATO medical support. All the operated patients were recorded in the OPEX registry. This study retrospectively included the trauma patient with chest injury. Results: The OPEX registry prospectively recorded 3181 patients operated in Combat Support Hospital from January 2009 to April 2013, 922 were wounded in action, and 89 had a chest injury. Forty four were admitted directly to the Combat Support Unit, 26 were transferred from the unit medical support, and nineteen from a Forward Surgical Team. The wounded were mainly young (mean: 27.9 years old), men (94%) and civilian (61%). Surgeons have to deal with polytraumatism (78%) with penetrating wound (96%). In most of cases, gunshot wound were noticed (53%) before injuries due to explosive devices (37%) and stab wounds (9%). Surgical approach chosen was laparotomy (49%), thoracotomy (36%) and cervicotomy (10%). Main injuries was hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), and heart or great vessels (20%) injuries. Surgeons performed diaphragmatic repair (n=25), lung resections (n=10), haemostasis (n=13) and overall mortality was near than 11%.Conclusion: The OPEX registry reports the military general surgeon experience in war chest trauma care.