title: Terror attacks increase the risk of vascular injuries.
abstract: OBJECTIVE
  Extensive literature exists about military trauma as opposed to the very limited literature regarding terror-related civilian trauma. However, terror-related vascular trauma (VT), as a unique type of injury, is yet to be addressed.
  
  
  METHODS
  A retrospective analysis of the Israeli National Trauma Registry was performed. All patients in the registry from 09/2000 to 12/2005 were included. The subgroup of patients with documented VT (N = 1,545) was analyzed and further subdivided into those suffering from terror-related vascular trauma (TVT) and non-terror-related vascular trauma (NTVT). Both groups were analyzed according to mechanism of trauma, type and severity of injury and treatment.
  
  
  RESULTS
  Out of 2,446 terror-related trauma admissions, 243 sustained TVT (9.9%) compared to 1302 VT patients from non-terror trauma (1.1%). TVT injuries tend to be more complex and most patients were operated on. Intensive care unit admissions and hospital length of stay was higher in the TVT group. Penetrating trauma was the prominent cause of injury among the TVT group. TVT group had a higher proportion of patients with severe injuries (ISS ≥ 16) and mortality. Thorax injuries were more frequent in the TVT group. Extremity injuries were the most prevalent vascular injuries in both groups; however NTVT group had more upper extremity injuries, while the TVT group had significantly much lower extremity injuries.
  
  
  CONCLUSIONS
  Vascular injuries are remarkably more common among terror attack victims than among non-terror trauma victims and the injuries of terror casualties tend to be more complex. The presence of a vascular surgeon will ensure a comprehensive clinical care.
authors.affiliation: Department of Vascular Surgery, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eitan
authors.initials: E
authors.lastname: Heldenberg
authors.affiliation: National Center for Trauma and Emergency Medicine Research, The Gertner Institute for Health Policy and Epidemiology , Tel Hashomer , Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Givon
authors.affiliation: Trauma Unit, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Simon
authors.affiliation: Department of Vascular Surgery, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Bass
authors.affiliation: Trauma Unit, Hadassah Medical Center, Hebrew University , Jerusalem , Israel.
authors.forename: Gidon
authors.initials: G
authors.lastname: Almogy
authors.affiliation: National Center for Trauma and Emergency Medicine Research, The Gertner Institute for Health Policy and Epidemiology , Tel Hashomer , Israel ; Department of Disaster Medicine, School of Public Health, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Kobi
authors.initials: K
authors.lastname: Peleg
keywords: blast; gun shot wounds; improvised explosive device; suicide bombers; terror-related trauma