• Mathieu Raux, Pierre Carli, Frédéric Lapostolle, Matthieu Langlois, Youri Yordanov, Anne-Laure Féral-Pierssens, Alexandre Woloch, Carl Ogereau, Etienne Gayat, Arié Attias, Dominique Pateron, Yves Castier, Anne François, Bertrand Ludes, Emmanuelle Dolla, Jean-Pierre Tourtier, Bruno Riou, and TRAUMABASE Group.
• Sorbonne Université, INSERM, UMRS1158, Paris, France. mathieu.raux@aphp.fr.
• Intensive Care Med. 2019 Sep 1; 45 (9): 1231-1240.

PurposeThe majority of terrorist acts are carried out by explosion or shooting. The objective of this study was first, to describe the management implemented to treat a large number of casualties and their flow together with the injuries observed, and second, to compare these resources according to the mechanism of trauma.MethodsThis retrospective cohort study collected medical data from all casualties of the attacks on November 13th 2015 in Paris, France, with physical injuries, who arrived alive at any hospital within the first 24 h after the events. Casualties were divided into two groups: explosion injuries and gunshot wounds.Results337 casualties were admitted to hospital, 286 (85%) from gunshot wounds and 51 (15%) from explosions. Gunshot casualties had more severe injuries and required more in-hospital resources than explosion casualties. Emergency surgery was required in 181 (54%) casualties and was more frequent for gunshot wounds than explosion injuries (57% vs. 35%, p < 0·01). The types of main surgery needed and their delay following hospital admission were as follows: orthopedic [n = 107 (57%); median 744 min]; general [n = 27 (15%); 90 min]; vascular [n = 19 (10%); median 53 min]; thoracic [n = 19 (10%); 646 min]; and neurosurgery [n = 4 (2%); 198 min].ConclusionThe resources required to deal with a terrorist attack vary according to the mechanism of trauma. Our study provides a template to estimate the proportion of various types of surgical resources needed overall, as well as their time frame in a terrorist multisite and multitype attack.FundingAssistance Publique-Hôpitaux de Paris.

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