MSSP576: MULTIFACETED ANALYSIS IN COMBAT TRAUMA PATIENTS IN MODERN WARFARE
Olena Grechanyk1; Rostyslav Bubnov2; Vitalii Gurianov3; Rizvan Abdallaiev4; 1National Military Medical Clinical Centre "Main Military Clinical hospital"; 2Clinical Hospital 'Pheophania'; 3Bogomolets National Medical University; 4Kharkiv National Medical University
Objective: To investigate and conduct clinical-epidemiological, organizational-diagnostic, ballistic, and statistical analyses in groups of combat trauma (CT) patients in modern warfare.
Materials and Methods: The results of clinical-epidemiological, organizational-diagnostic, and ballistic analyses in comparison groups, namely the control group (n=326 (90.3%) - survivors; n=35 (9.7%) - deceased) and the main group (n=583 (89.3%) - survivors; n=70 (10.7%) - deceased), were evaluated to identify the relationship between the risk of a lethal outcome and the type of combat trauma (firearm/non-firearm injury). The medical-statistical analysis was conducted using the STATISTICA software package, and the analysis results were transferred to the corresponding EXCEL spreadsheet.
Research Results: Examining the impact of the type of CT (non-firearm/firearm injury), gender of the injured, combat experience, use of personal protective equipment (protective helmets, body armor, etc.), and sanitary losses on the risk of a lethal outcome in patients with non-firearm injuries, firearm injuries (FI), explosive injuries (EI), and explosive trauma (ET) revealed the following:
The analysis groups did not differ in terms of gender, combat experience, and the risk of sanitary losses (p=0.780, p=0.265, and p=0.667, respectively).
A difference was observed between the groups (p<0.001) based on the type of CT; in the main group, a shift in the distribution towards EI (26.0%) and ET (36.9%) was observed compared to the control group - FI (16.1%) and ET (22.4%).
The use of personal protective equipment (PPE) was more frequent in the main group (84.7%) compared to the control group (70.1%) (the difference is statistically significant, p<0.001).
Factorial features related to the risk of a lethal outcome were identified in the control group - non-firearm trauma (15.9%) and explosive injury (13.8%) (p=0.036); no association with the type of CT was found in the main group (p=0.036).
Conclusions: To prevent lethal outcomes and achieve effective treatment of CT in patients with firearm and non-firearm injuries, it is necessary to consider the combat history of the injured (combat experience, use of PPE, circumstances of CT occurrence, use of firearms by the opponent for firearm injuries, etc.) and, in the future, pay attention to the search for effective methods of medical imagine of CT.