title: [Even more critical medicine: a retrospective analysis of casualties admitted to the intensive care unit in the Spanish Military Hospital in Herat (Afghanistan)].
abstract: OBJECTIVE
  To analyze casualties from firearm and explosives injuries who were admitted to the Intensive Care Unit in the Spanish ROLE-2E from December 2005 to December 2008 and to evaluate which damaging agent had produced the highest morbidity-mortality in our series using score indices with anatomical base (ISS and NISS).
  
  
  METHODS
  Observational and retrospective study performed between 2005 and 2008.
  
  
  METHODS
  Polyvalent Intensive Care Unit in the Spanish Military Hospital of those deployed in Afghanistan.
  
  
  METHODS
  The inclusion criteria were all patients who had been wounded by firearm or by explosive devices and who had been admitted in ICU in Spanish Military Hospital in Herat (Afghanistan).
  
  
  METHODS
  The anatomic scores Injury Severity Score and the New Injury Severity Score (NISS) were applied to all the selected patients to estimate the grade of severity of their injuries.
  
  
  METHODS
  Independent: damaging agent, injured anatomical area, protection measures and dependent: mortality, surgical procedure applied, score severity and socio-demographics and control variables.
  
  
  RESULTS
  Eighty-six casualties, 30 by firearm and 56 by explosive devices. Applying the NISS, 38% of the casualties had suffered severe injuries. Mean stay in the ICU was 2.8 days and mortality was 10%. Significant differences in admission to the ICU for the damaging agent were not observed (P=.142).
  
  
  CONCLUSIONS
  No significant differences were observed in the need for admission and stay in the ICU according to the damaging agent. The importance of the strategy, care and logistics of the intensive care military physician in Intensive Medicine in the Operating Room in Afghanistan is stressed.
authors.affiliation: Escuela Militar de Sanidad, Madrid, España. r_navarro_suay@yahoo.es
authors.forename: R
authors.initials: R
authors.lastname: Navarro Suay
authors.forename: E
authors.initials: E
authors.lastname: Bartolomé Cela
authors.forename: I
authors.initials: I
authors.lastname: Jara Zozaya
authors.forename: A
authors.initials: A
authors.lastname: Hernández Abadía de Barbará
authors.forename: C
authors.initials: C
authors.lastname: Gutiérrez Ortega
authors.forename: J D
authors.initials: JD
authors.lastname: García Labajo
authors.forename: A
authors.initials: A
authors.lastname: Planas Roca
authors.forename: F
authors.initials: F
authors.lastname: Gilsanz Rodríguez
mesh_terms: D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D001753:Blast Injuries / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D003422:Critical Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006772:Hospitals, Military / Q000145:classification / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000145:classification / Q000458:organization & administration / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008887:Military Medicine / Q000458:organization & administration; D008889:Military Personnel / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D010360:Patient Transfer / Q000706:statistics & numerical data; D016495:Police / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain; D013503:Surgery Department, Hospital / Q000145:classification / Q000458:organization & administration; D015599:Trauma Severity Indices; D014857:Warfare; D014948:Wounds, Gunshot / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D055815:Young Adult