Overview of polytrauma patients in the first 10 days after the Sichuan earthquake: a report from the No. 903 Military Hospital, Jiangyou

Are orthopaedic surgeons prepared? An analysis of severe casualties from the 2021 flash flood and mudslide disaster in Germany

Background

The purpose of this study was to describe and analyse the most severe casualties from the flash flood and mudslides occurring on 14 July 2021 in Germany, focusing on patients who were treated in the closest and largest level I trauma centre in the region the disaster occurred.

Methods

A single-centre retrospective study design was employed, and all patients treated because of the flooding and mudslides who needed inpatient treatment were documented. Data on each patient’s demographic characteristics, type of injury, number of surgeries, duration of hospitalisation, operation time, revision rate, injury severity score (ISS), and complications were collected. The primary outcome measure was status at discharge.

Results

Within the first week after the flood, a total of 63 patients were documented. Forty-one patients were treated on an outpatient basis in the emergency unit, and 22 patients were hospitalised. Of those hospitalised, 15 patients needed surgical treatment in the operation theatre. The most common injuries were fractures of the lower extremity (n = 7) and soft tissue wounds (n = 4). Overall, 20 surgeries were performed; the mean hospital stay was 7.2 ± 6.4 days, and the mean ISS was 5.7 ± 2.7.

Conclusion

The July 2021 flood disaster was one of the largest in German history. The included patients showed complex injuries of various types. Because of the effects of climate change, orthopaedic surgeons might face higher numbers of casualties affected by natural disasters. Learning more about the management and profile of these injuries can become a future challenge for orthopaedic and trauma surgeons.

Related Factors Associated With Earthquake Inpatient Mortality

OBJECTIVES

To date, we have only limited evidence of the determinants of earthquake inpatient mortality-related factors. This study is among the first to explore related factors of inpatient deaths using data from multiple hospitals and multiple earthquakes.

METHODS

We included and retrospectively analyzed data on 32,976 earthquake inpatients in the West China Earthquake Patients Database. Of these, we analyzed the records of 284 patients who died during hospitalization. We collected 12 dichotomous variables with reference to previous reports: patients' age (both ≤ 15 years and ≥ 65 years), gender, prehospital treatment, intensive care unit (ICU) admission, the presence of severe traumatic brain injury (TBI), trunk injury, severe poly-trauma, crush syndrome, multiple-system organ failure (MSOF), infection, and cardiac/respiratory disease. We performed multivariate logistic regression analysis to explore independent related factors of mortality.

RESULTS

Ultimately, we identified severe TBI, MSOF, old age (≥ 65 years), ICU admission, crush syndrome, and cardiac/respiratory disease as independent mortality-related factors. Severe TBI was the greatest risk factor of inpatient death (ods ratio [OR], 31.913, 95% confidence interval [CI], 20.484-49.720), followed by MSOF (OR 30.905, 95% CI, 21.733-43.947).

CONCLUSION

To reduce earthquake inpatient mortalities, the related factors analyzed in this study should be prioritized in future inpatient earthquake response strategies.