title: Two New York City hospitals' surgical response to the September 11, 2001, terrorist attack in New York City.
abstract: BACKGROUND
  We describe the surgical response of two affiliated hospitals during the day of, and week following, the September 11th, 2001 terrorist attack at the World Trade Center in New York City. The city of New York has 18 state designated regional trauma centers that receive major trauma victims. The southern half of Manhattan is served by a burn center, two regional trauma centers, and a community hospital that is an affiliate of one of the regional trauma centers. This report accounts for the surgical response by a regional trauma center (Hospital A, located 2.5 miles from the World Trade Center) and its affiliate hospital (Hospital B, located 5 city blocks from the World Trade Center) on September 11th when two commercial jets crashed into the Twin Towers at the World Trade Center mall.
  
  
  METHODS
  Hospital A maintained a concurrent log of patients received during the first 5 hours, the first day, and the first week after the disaster which was kept by the Surgical Triage Officer. The trauma registry completed and verified this data by September 18th. Hospital B collected its data by hand counting and verification by chart review. Both hospitals, A and B, had established disaster plans that were implemented.
  
  
  RESULTS
  Nine hundred eleven patients were received by two affiliated hospitals from the World Trade Center attack. Seven hundred seventy six patients (85%) were walking wounded, sustaining mild inhalation and eye irritant injuries. One hundred thirty five (15%) were admitted with 18 (13%) of these undergoing surgery. Twenty two of the 23 transfers were from the community hospital to specialized orthopedic or burn centers. Of the 109 patients admitted to Hospital A, 30 were to the surgical service. The mean ISS score of these patients was 12. There were 4 deaths (within minutes of arrival at the hospital) and 6 delayed deaths (day 1-14). Excluding walking wounded and DOAs, the critical mortality rate was 37.5% overall.
  
  
  CONCLUSIONS
  The September 11th, 2001, terrorist attack in New York City, involving two commercial airliners crashing into the World Trade Center, led to 911 patients received at two affiliated hospitals in lower Manhattan. One hospital is a regional trauma center and one was an affiliate community hospital. Eighty five percent of the patients received were walking wounded. Of the rest, 13% underwent surgical procedures with an overall critical mortality rate of 37.5%.
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York, USA. cushmanj@msn.com
authors.forename: James G
authors.initials: JG
authors.lastname: Cushman
authors.forename: H Leon
authors.initials: HL
authors.lastname: Pachter
authors.forename: Howard L
authors.initials: HL
authors.lastname: Beaton
mesh_terms: D001359:Aviation; D004189:Disaster Planning / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006302:Health Services Research; D017052:Hospital Mortality; D006764:Hospitals, Community / Q000458:organization & administration*; D006786:Hospitals, Urban / Q000458:organization & administration*; D006801:Humans; D015601:Injury Severity Score; D008485:Medical Audit; D009519:New York City / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D012189:Retrospective Studies; D023481:Terrorism / Q000706:statistics & numerical data; D013997:Time Factors; D014193:Trauma Centers / Q000458:organization & administration*; D014218:Triage / Q000458:organization & administration; D014947:Wounds and Injuries / Q000401:mortality / Q000601:surgery*