title: Mechanism of injury and microbiological flora of the geographical location are essential for the prognosis in soldiers with serious warfare injuries.
abstract: BACKGROUND
  Denmark has been engaged in the Afghanistan war and as a result, Rigshospitalet has received a number of multi-traumatized Danish soldiers. Lesions sustained in armed conflict differ from their civilian counterparts and knowledge of the pathophysiology related to these types of lesions is essential when engaging in the intensive care of these patients.
  
  
  METHODS
  The study was conducted as a retrospective survey of Danish soldiers evacuated from Afghanistan to the Intensive Care Unit at Rigshospitalet in the 2002-2012 period. The following data were recorded: age, gender, hospitalization (days), mortality, organ involvement, respiratory therapy, dialysis, circulatory supportive care, antibiotic treatment and bacteriology. Furthermore, Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score and Sequential Organ Failure Assessment scores were calculated.
  
  
  RESULTS
  A total of twenty patients were identified and included in the study. All patients had sustained serious blast injuries as a result of explosion. Primarily the central nervous system, respiratory, musculoskeletal and abdominal systems were affected by the explosions. Eighteen patients survived to discharge and two patients died.
  
  
  CONCLUSIONS
  Explosion was the most frequent cause of injury in all cases and caused damage to several organ systems. Infections after combat injuries are a major problem because of the different microbiological profile.
  
  
  CONCLUSIONS
  The use of explosives has been and remains a substantial part of warfare, and this review has showed us that the knowledge of the mechanism of injury is indeed essential, and that intelligence on the microbiological flora of the geographical location of the conflict is essential.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Department of Cardiothoracic Anaesthesiology and Intensive Care 4141, Rigshospitalet, 2100 Copenhagen, Denmark.
authors.forename: Mik
authors.initials: M
authors.lastname: Wetterslev
authors.forename: Katrine
authors.initials: K
authors.lastname: Rose-Larsen
authors.forename: Jacob
authors.initials: J
authors.lastname: Hansen-Schwartz
authors.forename: Jacob
authors.initials: J
authors.lastname: Steen-Andersen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Møller
authors.forename: Hasse
authors.initials: H
authors.lastname: Møller-Sørensen
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery; D000151:Acinetobacter Infections / Q000188:drug therapy; D040981:Acinetobacter baumannii; D000328:Adult; D055826:Afghan Campaign 2001-; D000671:Amputation, Surgical; D001753:Blast Injuries / Q000150:complications* / Q000382:microbiology* / Q000628:therapy; D002490:Central Nervous System / Q000293:injuries; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000188:drug therapy; D003422:Critical Care; D003718:Denmark; D004756:Enterobacteriaceae Infections / Q000188:drug therapy; D004777:Environment; D004783:Environmental Microbiology; D005121:Extremities / Q000293:injuries / Q000601:surgery; D006491:Hemothorax / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008889:Military Personnel; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012769:Shock / Q000209:etiology; D055815:Young Adult