Gunshot and improvised explosive casualties: a report from the Spanish Role 2 medical facility in Herat, Afghanistan.

OBJECTIVE

To provide an analysis of casualties treated during medical evacuation (MEDEVAC) or/and at the Spanish Role 2 in Herat, Afghanistan, including type of weapon, injuries, and effects of protective measures.

METHOD: A retrospective analysis was carried out concerning patients who had suffered injuries from either gunshot or explosive devices treated during MEDEVAC or/and at this facility during the period 2005-2008.

RESULTS

The total number of cases analyzed was 256. The majority of the casualties were produced by explosive devices (71%). The anatomical regions most affected were the lower limbs (48%). There was a higher New Injury Severity Score in casualties wounded by gunshot (14 +/- 1) than in those wounded by explosive devices (8.5 +/- 1.5) (p < 0.001). Surgical procedures for injuries caused by gunshots were 1.7 times more likely than for those due to explosive devices (95% confidence interval: 1.4 to 2.1). Protective devices were used only by 25% of casualties.

CONCLUSIONS

The injury score indices of firearm casualties were higher than the explosive device casualties' injury score indices. The possible reasons for this finding are discussed.