title: Pediatric trauma: experience of a combat support hospital in Iraq.
abstract: OBJECTIVE
  The mission of the combat support hospital (CSH) is to evaluate and treat combatants injured during war operations. The 31st CSH in Balad and Baghdad, Iraq, during Operation Iraqi Freedom 2 also treated many injured civilians, including children. The purpose of this article is to report the experience of the 31st CSH treating pediatric trauma patients.
  
  
  METHODS
  A retrospective review of a comprehensive patient database collected in theater was conducted.
  
  
  RESULTS
  From January 1 to December 31, 2004, we treated 99 patients 17 years and younger. The average age of these patients was 10.6 years. Nine died of their wounds. The mean injury severity score was 11.6. Forty-one sustained gunshot wounds, 13 acquired fragment wounds (55% penetrating), and 22 were injured by improvised explosive devices (22%). Seventy-three patients required a total of 191 operations: 18 celiotomies, 8 craniotomies, 23 skeletal fixations, and 75 wound washout/debridements, among others. Predictors of mortality included admission Glasgow Coma Score less than 4 and admission pH less than 7.1.
  
  
  CONCLUSIONS
  The primary mission of the CSH in theater remains unchanged, but its role is evolving. With this study, we can begin to understand the needs of wounded children in urban conflict and help guide training and resource allocation in the future.
authors.affiliation: Martin Army Community Hospital, Fort Benning, GA 31905, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: McGuigan
authors.forename: Philip C
authors.initials: PC
authors.lastname: Spinella
authors.forename: Alec
authors.initials: A
authors.lastname: Beekley
authors.forename: James
authors.initials: J
authors.lastname: Sebesta
authors.forename: Jeremy
authors.initials: J
authors.lastname: Perkins
authors.forename: Kurt
authors.initials: K
authors.lastname: Grathwohl
authors.forename: Kenneth
authors.initials: K
authors.lastname: Azarow
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007493:Iraq; D008297:Male; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014857:Warfare; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy