Injuries and infections in 37 casualties from the 2014 Gaza war: a descriptive study

Abstract

Background215 casualties were evacuated to the West Bank and East Jerusalem for treatment during the conflict in Gaza in 2014. We aimed to describe injuries and infections in Gazan patients receiving treatment at two East Jerusalem hospitals. Methods37 patients were included in a convenience sample using two inclusion criteria: transfer from Gaza to East Jerusalem between July 8 and August 30, 2014, and a war injury. 46 patients were invited and 44 participated after providing written consent. Seven were excluded because of ethical considerations (n=4) or lack of documented war injury (n=3). Data were obtained from the patients’ medical files. Trauma severity was assessed using the Injury Severity Score (ISS), ranging from 1 to 75, based on the Abbreviated Injury Scale (AIS), ranging from 1 (minor) to 6 (untreatable) for each anatomical region. Bacteriology was assessed at Jerusalem hospitals. Birzeit University's research ethics committee approved the study. Findings19 male and 18 female patients aged 9 months to 53 years were included. The patients sustained injuries from weapons (n=19), other (n=16), or unknown causes (n=2), in the head or neck (n=14; mean AIS 3·4, SD 1·7), face (n=7; 2·9, 1·3), chest (n=6; 2·8 0·4), abdomen (n=6; 3·3, 0.5), extremities (n=21; 3·1, 1·1), and externally (n=31; 1·9, 0·8). The median ISS score was 17 (interquartile range 95–29). The main mechanism was blast injury. Shrapnel, crush, and burns were the most common injury types, resulting predominantly in wounds (n=30) and fractures (n=28). 25 patients had at least one positive bacterial culture. Four had obvious infection without microbiological data. Acinetobacter spp was the most common pathogen (n=16). InterpretationThe patients in this study endured traumas of differing severity. Physical and psychological sequelae are likely. Our sample is not representative of the 11 000 injured during the war. Seen in a larger context, global efforts are needed to rehabilitate injured people and rebuild Palestinian society in Gaza. FundingS G Sønneland Foundation.