title: The Syrian civil war: The experience of the Surgical Intensive Care Units.
abstract: OBJECTIVE
  Since the civilian war in Syria began, thousands of seriously injured trauma patients from Syria were brought to Turkey for emergency operations and/or postoperative intensive care. The aim of this study was to present the demographics and clinical features of the wounded patients in Syrian civil war admitted to the surgical intensive care units in a tertiary care centre.
  
  
  METHODS
  The records of 80 trauma patients admitted to the Anaesthesia, General Surgery and Neurosurgery ICUs between June 1, 2012 and July 15, 2014 were included in the study. The data were reviewed regarding the demographics, time of presentation, place of reference, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Injury Severity Score (ISS), surgical procedures, complications, length of stay and mortality.
  
  
  RESULTS
  A total of 80 wounded patients (70 males and 10 females) with a mean age of 28.7 years were admitted to surgical ICUs. The most frequent cause of injury was gunshot injury. The mean time interval between the occurrence of injury and time of admission was 2.87 days. Mean ISS score on admission was 21, and mean APACHE II score was 15.7. APACHE II scores of non-survivors were significantly increased compared with those of survivors (P=0.001). No significant differences was found in the age, ISS, time interval before admission, length of stay in ICU, rate of surgery before or after admission.
  
  
  CONCLUSIONS
  The most important factor affecting mortality in this particular trauma-ICU patient population from Syrian civil war was the physiological condition of patients on admission. Rapid transport and effective initial and on-road resuscitation are critical in decreasing the mortality rate in civil wars and military conflicts.
authors.affiliation: Hatice Kaya Ozdogan, MD. Dept. of Anaesthesiology and Reanimation, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hatice Kaya
authors.initials: HK
authors.lastname: Ozdogan
authors.affiliation: Faruk Karateke, MD. Dept. of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Karateke
authors.affiliation: Mehmet Ozdogan, MD. Professor of Surgery, Dept. of General Surgery, Medline Hospital, Adana, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozdogan
authors.affiliation: Sibel Cetinalp, MD. Dept. of Anaesthesiology and Reanimation, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Cetinalp
authors.affiliation: Sefa Ozyazici, MD. Dept. of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Sefa
authors.initials: S
authors.lastname: Ozyazici
authors.affiliation: Yurdal Gezercan, MD. Dept. of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Yurdal
authors.initials: Y
authors.lastname: Gezercan
authors.affiliation: Ali Ihsan Okten, MD. Dept. of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Okten
authors.affiliation: Muge Celik, MD. Dept. of Anaesthesiology and Reanimation, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Muge
authors.initials: M
authors.lastname: Celik
authors.affiliation: Salim Satar, MD. Associate Professor of Emergency Medicine, Dept. of Emergency Medicine, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Salim
authors.initials: S
authors.lastname: Satar
keywords: APACHE II; Civil war; Injury Severity Score (ISS); Intensive care; Syrian