title: Trauma management in a war zone: the Lebanese war experience.
abstract: Lessons learned from the Vietnam and Korean conflicts have emphasized the necessity of an organized preparedness for optimal management of casualties. The present report summarizes the experience of a tertiary care center in the present Lebanese war. Between 1975 and 1986, approximately 30,000 war casualties were treated at the American University of Beirut Medical Center (AUBMC). A disaster plan was implemented whenever more than 25 major trauma victims were received within 1 hour. In-field stabilization and emergency room (ER) thoracotomy were not employed. The results are illustrated by an analysis of 1,500 cases of abdominal trauma, (1,314 high-velocity gunshot wounds, 29 stab wounds, 157 blunt injuries). A total of 1,420 patients were operated on within 6 hours of admission and 711 within the first hour. Overall mortality was 130, 8.7%; 9.5% for gunshot wounds, 3.4% for stab wounds, and 2.5% for blunt trauma. One hundred forty-five patients or 9.7% had negative findings at laparotomy. The factors affecting mortality were hypotension on admission (26.5% for a BP less than 90 mm Hg and 2.8% for a BP higher than 90 mm Hg) and the presence of extra-abdominal injuries (14.4% with and 4.4% without). The chief causes of death were hemorrhage (3.7%), sepsis (2.1%), and ARDS (1.2%).
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Lebanon.
authors.forename: Z
authors.initials: Z
authors.lastname: Nassoura
authors.forename: H
authors.initials: H
authors.lastname: Hajj
authors.forename: O
authors.initials: O
authors.lastname: Dajani
authors.forename: N
authors.initials: N
authors.lastname: Jabbour
authors.forename: M
authors.initials: M
authors.lastname: Ismail
authors.forename: T
authors.initials: T
authors.lastname: Tarazi
authors.forename: G
authors.initials: G
authors.lastname: Khoury
authors.forename: F
authors.initials: F
authors.lastname: Najjar
mesh_terms: D000007:Abdominal Injuries / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014218:Triage; D014857:Warfare