Mortality pattern of the 26/11 Mumbai terror attacks.
BACKGROUND
Mumbai, one of the industrial capitals cities of the world, has witnessed a series of terror attacks over the last two decades. The 2008 Mumbai terror attacks referred as "26/11" drew widespread global condemnation and killed 166 people, in addition to wounding more than 300 people. The mortality pattern and the pathophysiology of organ injuries are presented. The objective of this study was to determine the different patterns of injury in a terrorist attack of such magnitude and clinical implications in reducing mortality.


METHODS
Data were collected from hospital records of 114 victims whose postmortems were conducted at the Sir JJ Group of Hospitals. The records were studied with respect to pattern and nature of injury.


RESULTS
A total of 175 people were killed, 9 were terrorist with 166 victims. Of the 166 mortalities, postmortems were conducted on 114 predominately male victims ages 5 to 70 years old; 108 of these were dead on arrival. Sixty-eight people died from bullet injuries, 30 from blast injuries, and 10 had both bullet and blast injuries. Six were postoperative deaths (all bullet injuries), of which two were early postoperative deaths and four late postoperative deaths due to septicemia.


CONCLUSIONS
There was multimodal pattern of injuries with predominance of bullet injuries sustained to vital organs. The hostage crisis resulted in varied and delayed evacuation times, which led to the death of nine victims with non-severe organ injuries. Delayed implementation of Prehospital Trauma Life Support due to the unsecured site and the hostage crisis can also be one of the causes.


METHODS
V, epidemiological study.
Departments of General Surger, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India. abhandarwar@gmail.com
Ajay H
AH
Bhandarwar
Girish D
GD
Bakhshi
Mukund B
MB
Tayade
Gajanan S
GS
Chavan
Sachin S
SS
Shenoy
Ashish S
AS
Nair
D000293:Adolescent; D000328:Adult; D000368:Aged; D001753:Blast Injuries / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005107:Explosions; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D023481:Terrorism; D015599:Trauma Severity Indices; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D055815:Young Adult