title: Gunshot and improvised explosive casualties: a report from the Spanish Role 2 medical facility in Herat, Afghanistan.
abstract: OBJECTIVE
  To provide an analysis of casualties treated during medical evacuation (MEDEVAC) or/and at the Spanish Role 2 in Herat, Afghanistan, including type of weapon, injuries, and effects of protective measures.
  
  
  METHODS
  A retrospective analysis was carried out concerning patients who had suffered injuries from either gunshot or explosive devices treated during MEDEVAC or/and at this facility during the period 2005-2008.
  
  
  RESULTS
  The total number of cases analyzed was 256. The majority of the casualties were produced by explosive devices (71%). The anatomical regions most affected were the lower limbs (48%). There was a higher New Injury Severity Score in casualties wounded by gunshot (14 +/- 1) than in those wounded by explosive devices (8.5 +/- 1.5) (p < 0.001). Surgical procedures for injuries caused by gunshots were 1.7 times more likely than for those due to explosive devices (95% confidence interval: 1.4 to 2.1). Protective devices were used only by 25% of casualties.
  
  
  CONCLUSIONS
  The injury score indices of firearm casualties were higher than the explosive device casualties' injury score indices. The possible reasons for this finding are discussed.
authors.affiliation: Grupo de Escuelas de la Defensa, Escuela Militar de Sanidad, Camino de los Ingenieros n 6, CP: 28071 Madrid, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Navarro Suay
authors.forename: Alberto Hernández
authors.initials: AH
authors.lastname: Abadía de Barbará
authors.forename: Carlos
authors.initials: C
authors.lastname: Gutierrez Ortega
authors.forename: Enrique
authors.initials: E
authors.lastname: Bartolomé Cela
authors.forename: David M
authors.initials: DM
authors.lastname: Lam
authors.forename: Fernando
authors.initials: F
authors.lastname: Gilsanz Rodríguez
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000453:epidemiology*; D006259:Craniocerebral Trauma / Q000453:epidemiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007869:Leg Injuries / Q000453:epidemiology; D008297:Male; D008889:Military Personnel; D011482:Protective Devices; D012189:Retrospective Studies; D013030:Spain; D014948:Wounds, Gunshot / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult