Introduction: The Syrian uprising has entered its third year of fighting with over 130,000 lives lost and millions displaced with considerable disruption of their medical services. Since March of 2013, our hospital has been receiving Syrian nationals injured in the ongoing military conflict, crossing over the border in coordination with the Israel Defense forces.
Methods: A retrospective medical chart review from 1st of March of 2013 to 31st of December 2013 of all syrian nationals brought to the Emergency Room of the Western Galilee Medical Center to identify all patients harboring cranio-cerebral injuries.
Results: Forty patients were admitted to our department, 37 male and 3 female patients with a mean age of 22 years (4 – 30). Injuries could be divided in blunt trauma (18), penetrating injury including gun shot wound (17) and blast injury (3). Traumatic lesions as defined by CT included EDH(4) and ASDH (4), contusions (26). Mean GCS on admission was 10 (3-15). Neurological deficit was present in 15 patients that were able to be evaluated in the ER, pupillary dilation secondary to brain herniation in 6 patients. Twenty-six patients underwent a craniotomy and ICP monitor was inserted in 15. Surprisingly, in respect with the severity and the military volume of injuries, there were only two deaths. The mean LOS in the NICU was 5.6 days and a mean total LOS of 18 days. The outcome as measured by the GOS was good in 32 pts and poor in 10 pts.
Conclusions: Neurological injuries carry a high morbid-mortality. The outcomes of this series was unexpectedly favorable. This may be explained by the extremely lengthy transport of patients, often stretched for several days preventing patients with the worst injuries to reach the border. Nevertheless, these results suggest that penetrating injuries may carry better prognosis than usually assumed.
Patient Care: By identifying patients with higher odds of favorable outcome.
Learning Objectives: Better understand the impact of evacuation time on survival outcome in order to help identifying patients with higher odds of favorable outcome.