title: Explosive attack: Lessons learned in Seyed Al Shohada mosque attack, April 2008, Shiraz, Iran.
abstract: BACKGROUND
  The threat of explosive attacks has become a worldwide problem. Bombing is the preferred method of attacks. These attacks result in specific physical and psychiatric trauma. In this paper, we present an epidemiologic description of the physical injuries of patients who survived the explosive attack in Seyed Al Shohada mosque April 2008 Shiraz, Iran.
  
  
  METHODS
  All medical records of the patients admitted at Shiraz Hospitals on April 2008 due to Seyed Al Shohada mosque bombing attacks, Shiraz, Iran, were reviewed.
  
  
  RESULTS
  A total of 202 patients were referred to the hospitals over 24 h following the terrorist attack. One hundred sixty-four patients were admitted for short periods of observation (<24 h). Thirty-eight patients needed more than 1 day of hospitalization. The mean age of the patients was 26.2 (range 2 to 51) years. One hundred thirty-five (66.8%) patients were males. Twenty-six (12.8%) were children. Burn was the most prevalent cause of admission. Five (13.5%) patients needed chest tube insertion and eight (21%) needed skin grafts due to burn. Overall, 12 patients expired (5%). Three (25%) of them were children (2 and 6, and 11 years old). Mortality rate was significantly higher among the children than adults (P value <0.05). The most important cause of death was head trauma which was seen in five (41.6%) of the expired patients followed by burn (including air way burn) in four (33%), and internal bleeding in three (25%). Patients with head trauma had significantly a higher rate of mortality than other patients (P value <0.05).
  
  
  CONCLUSIONS
  Following a bombing attack, numerous victims were brought to the emergency unit suffering from a combination of multi-organ injuries caused by the blast, penetrating injuries caused by shrapnel and other debris, and burns. It is important for a physician to be familiar with the clinical features and treatments of explosive attacks victims. Early management of patients at the scene and hospital may save their life.
authors.affiliation: Department of General Surgery, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Paydar
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharifian
authors.forename: Shahram Boland
authors.initials: SB
authors.lastname: Parvaz
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Abbasi
authors.forename: Mohamad Javad
authors.initials: MJ
authors.lastname: Moradian
authors.forename: Jamshid
authors.initials: J
authors.lastname: Roozbeh
authors.forename: Saman
authors.initials: S
authors.lastname: Nikghbalian
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Sagheb
authors.forename: Fariborz
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authors.lastname: Ghaffarpasand
authors.forename: Oveis
authors.initials: O
authors.lastname: Salehi
authors.forename: Javad
authors.initials: J
authors.lastname: Dehghani