Analysis of combat casualties admitted to the emergency department during the negotiation of the comprehensive Colombian process of peace
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Aim: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016.
Methods: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period). Variables were compared with respect to periods
Results: A total of 448 hostile casualties were registered. There was a gradual decline in the number of admissions to the emergency department during the negotiation period. The number of soldiers suffering blast and rifle injuries also decreased over this period. In 2012 there were nearly 150 hostile casualties' admissions to the ER. This number decreased to 84, 63, 32 and 6 in 2013, 2014, 2015 and 2016 respectively. Both, the proportion of patients with an ISS ≥9 and admitted to the intensive care unit were significantly higher in the period before peace negotiation. From August to December/2016 no admissions of war casualties were registered.
Conclusion: We describe a series of soldiers wounded in combat that were admitted to the emergency department before and during the negotiation of the Colombian process of peace. Overall, we found a trend toward a decrease in the number of casualties admitted to the emergency department possibly in part, as a result of the period of peace negotiation.
- Peace
- Casualty
- Military Medicine
- Acute Care Surgery
- Casualty outcomes
Red Nacional de Información. Registro Único de Víctimas (Colombian Victims Registry). Bogotá: Unidad para las victimas; http://rni.unidadvictimas.gov.co/RUV.
Rubiano AM, Sánchez ÁI, Guyette F, Puyana JC. Trauma care training for national police nurses in Colombia. Prehosp Emerg Care. 2010;14(1):124-30. DOI: https://doi.org/10.3109/10903120903349762
Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC. The global burden of injury incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2015; 22(1): 3-18. DOI: https://doi.org/10.1136/injuryprev-2015-041616
Murray CJL, King G, Lopez AD, Tomijima N, Krug EG. Armed conflict as a public health problem. BMJ. 2002; 324: 34-9. DOI: https://doi.org/10.1136/bmj.324.7333.346
Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P. Death on the battlefield (2001-2011) Implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012; 73(6): S431-7. DOI: https://doi.org/10.1097/TA.0b013e3182755dcc
Belmont PJJ, Goodman GP, Zacchilli M, Posner M, Evans C, Owens BD. Incidence and epidemiology of combat injuries sustained during the surge portion of operation Iraqi freedom by a U S. Army Brigade Combat Team. J Trauma Acute Care Surg. 2010; 68(1): 204-10. DOI: https://doi.org/10.1097/TA.0b013e3181bdcf95
Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT. Injury severity and causes of death from operation Iraqi Freedom and operation enduring freedom 2003-2004 Versus 2006. J Trauma Acute Care Surg. 2008; 64(2): s21–7. DOI: https://doi.org/10.1097/TA.0b013e318160b9fb
Antebi B, Benov A, Mann-Salinas EA, Le TD, Cancio LC, Wenke JC. Analysis of injury patterns and roles of care in US and Israel militaries during recent conflicts Two are better than one. J Trauma Acute Care Surg. 2016; 81(5): S87–S94. DOI: https://doi.org/10.1097/TA.0000000000001252
Camargo J, Pérez LE, Franco C, Rodríguez E, Sánchez W. "Plan Pantera" trauma militar en Colombia. Rev Colomb. Cir. 2014; 29(4): 293-304. DOI: https://doi.org/10.30944/20117582.424
Department of Defense. Dictionary of Military and Associated Terms. US Department of Defense. Joint Publication. 2015. p. 105. https://fas.org/irp/doddir/dod/jp1_02.pdf.
BBC. Colombia: FARC declares unilateral truce at landmark talks. BBC news; 2012. Accessed: 2017 Jan 11. Available from: http://www.bbc.com/news/world-latin-america-20399152.
Holcomb JB, Stansbury LG, Champion HR, Wade C, Bellamy RF. Understanding combat casualty care statistics. J Trauma Acute Care Surg. 2006; 60(2): 397–401. DOI: https://doi.org/10.1097/01.ta.0000203581.75241.f1
Gawande A. Casualties of War - Military Care for the Wounded from Iraq and Afghanistan. N Engl J Med. 2004; 351(24): 2471–5. DOI: https://doi.org/10.1056/NEJMp048317
Dean DJ. The air force role in low-intensity conflict. Washintong: Air University Press; 1986. p. 2.
Arias C, Villamil E, Gutierrez J, Morales H, Sanchez W. Trauma vascular periférico de guerra en Colombia análisis epidemiológico de ocho años. Rev Colomb Cir. 2012; 2(Suppl): 26.
Lindskog EE. The effect of war on infant mortality in the Democratic Republic of Congo. BMC Public Health. 2016; 16: 1059. DOI: https://doi.org/10.1186/s12889-016-3685-6
Herp Van M, Parqué V, Rackley E, Ford N. Mortality, violence and lack of access to healthcare in the Democratic Republic of Congo. Disasters. 2003; 27(2): 141–53. DOI: https://doi.org/10.1111/1467-7717.00225
Li S-J, Flaxman A, Lafta R, Galway L, Takaro TK, Burnham G. A Novel method for verifying war mortality while estimating Iraqi deaths for the Iran-Iraq war through operation Desert Storm (1980-1993). PLoS One. 2016; 11(10): e0164709. DOI: https://doi.org/10.1371/journal.pone.0164709
Joshi M. Comprehensive peace agreement implementation and reduction in neonatal, infant and under-5 mortality rates in post-armed conflict states, 1989--2012. BMC Int Health Hum Rights. 2015; 15(1): 27. DOI: https://doi.org/10.1186/s12914-015-0066-7
Gaffar AM, Mahfouz MS. Peace impact on health: population access to iodized salt in south Sudan in post-conflict period. Croat Med J. 2011; 52(2): 178–82. DOI: https://doi.org/10.3325/cmj.2011.52.178
Mizobata Y. Damage control resuscitation a practical approach for severely hemorrhagic patients and its effects on trauma surgery. J Intensive Care. 2017; 5(1): 4. DOI: https://doi.org/10.1186/s40560-016-0197-5
Holcomb JB. Damage control resuscitation. J Trauma Acute Care Surg. 2007; 62(6): s36–7. DOI: https://doi.org/10.1097/TA.0b013e3180654134
Mathews AL, Cheng M-H, Muller J-M, Lin MC-Y, Chang KWC, Chung KC. Cost analysis of 48 burn patients in a mass casualty explosion treated at Chang Gung Memorial Hospital. Injury. 2017; 48(1): 80–6. DOI: https://doi.org/10.1016/j.injury.2016.08.007
Edwards DS, Phillip RD, Bosanquet N, Bull AMJ, Clasper JC. What is the magnitude and long-term economic cost of care of the British Military Afghanistan amputee cohort. Clin Orthop Relat Res. 2015; 473(9): 2848–55. DOI: https://doi.org/10.1007/s11999-015-4250-9
Masini BD, Waterman SM, Wenke JC, Owens BD, Hsu JR, Ficke JR. Resource utilization and disability outcome assessment of combat casualties from operation Iraqi freedom and operation enduring freedom. J Orthop Trauma. 2009; 23(4): 261–6. DOI: https://doi.org/10.1097/BOT.0b013e31819dfa04
Lundy JB, Swift CB, McFarland CC, Mahoney LCP, Perkins RM, Holcomb JB. A descriptive analysis of patients admitted to the intensive care unit of the 10th combat support hospital deployed in Ibn Sina, Baghdad, Iraq, from October 19, 2005, to October 19, 2006 J Intensive Care Med. J Inten Care Med. 2010; 25(3): 156–62. DOI: https://doi.org/10.1177/0885066609359588
Lockey DJ, Nordmann GR, Field JM, Clough D, Henning JDR. The deployment of an intensive care facility with a military field hospital to the 2003 conflict in Iraq. Resuscitation. 2017; 62(3): 261–5. DOI: https://doi.org/10.1016/j.resuscitation.2004.06.003
Cho JM, Jatoi I, Alarcon AS, Morton TM, King BT, Hermann JM. Operation Iraqi Freedom surgical experience of the 212th Mobile Army Surgical Hospital. Mil Med. 2005; 170(4): 268–72. DOI: https://doi.org/10.7205/MILMED.170.4.268
Lin DL, Kirk KL, Murphy KP, McHale KA, Doukas WC. Evaluation of orthopaedic injuries in operation enduring freedom. J Orthop Trauma. 2004; 18(5): 300–5. DOI: https://doi.org/10.1097/00005131-200405000-00006
Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P. Death on the battlefield (2001-2011). J Trauma Acute Care Surg. 2012; 73: S431–7. DOI: https://doi.org/10.1097/TA.0b013e3182755dcc
CERAC. Assessing the merits of an imperfect peace: The FARC's unilateral ceasefire in 2013-14. Blog CERAC; 2014. Accessed: 11 Jan 2017. Available from: http://blog.cerac.org.co/assessing-the-merits-of-an-imperfect-peace-the-farcs-unilateral-ceasefire-in-2013-14.
El Espectador. Hace 51 años no se presentaba una reducción tan grande del conflicto armado. Cerac. 2016. Accessed: 11 Jan 2017. Available from: http://www.elespectador.com/noticias/politica/hace-51-anos-no-se-presentaba-una-reduccion-tan-grande-articulo-611701.
Valencia CF, Suarez JA, Cogollos A, Uribe RA, Flores GC. Heridos de combate, experiencia del grupo de Trauma del Hospital Militar Central de Bogotá. Rev Colomb Cir. 2015; 30: 18–23.. DOI: https://doi.org/10.30944/20117582.315
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