M. Rajaei1, R. Griffin2, P. Hu1, T. Swain2, J. Kerby1 1UAB,Division Of Acute Care Surgery, Department Of Surgery, School Of Medicine,Birmingham, ALABAMA, USA 2UAB,Department Of Epidemiology, School Of Public Health,Birmingham, ALABAMA, USA
Introduction: Since 1900, natural disasters in the United States have affected more than 26.5 million people and caused almost $737 billion in damage. Tornadoes are common in North America, where the majority of the 1,000 annual tornadoes occur. These disasters result in hundreds of deaths and further injuries every year. Studying the most common injuries and associated operative interventions in the aftermath of the disasters contributes to more efficient mass casualty management. The purpose of this study was to describe the most prevalent injuries and operative procedures perform on victims of tornadoes in the United States.
Methods: A cross-sectional study was performed using National Trauma Data Bank. Tornado-related injuries were identified using ICD-9 codes. Patient information was collected on demographic, injury location, procedures, and clinical characteristics. Injury severity was measured by Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), and Glasgow Coma Scale (GCS).
Results: From 2003-2013, 1,059 individual-injuries were included. Age was 44±39 years with 53% female. The length of hospital and ICU stay were 10±23 and 8±16 days respectively. The average ISS and GCS were 17±22 and 13±5, with 24.6% having a GCS < 8. Most common injury locations were thorax (53.3%), head (52.2%), lower (51.7%) and upper (53.6%) extremities. Severe injuries happened most commonly in the thorax (40.0%), head (15.2%), and lower extremities (15.2%). Head (85.6%), thorax (79.9%), and spinal (64.3%) injuries were the most common injuries among fatal cases. Severe thoracic injuries occurred nearly twice as common as severe head injuries in patient who didn’t survive the incidents (66.3% vs. 35.9%). Patients were equally admitted to the ICU (35.6%) or regular floor (31.5%) with 20.1% requiring operative intervention prior to admission. The most common procedures were performed on skin/ soft tissue (17.9%); fractures/ dislocations (16.9%); injured vessels (11.0%); chest (7.9%); and muscle/ tendons (5.6%).
Conclusion: ~~Head and thoracic injuries were most common in tornadoes, with the latter being the most prevalent severe injury associated with mortality. While more study is needed, these data could potentially inform disaster preparedness and injury prevention approaches.
