Mortality pattern of the 26/11 Mumbai terror attacks

Bhandarwar, Ajay H.; Bakhshi, Girish D.; Tayade, Mukund B; Chavan, Gajanan; Shenoy, Sachin S.; Nair, Ashish

doi:10.1097/ta.0b013e31824da04f

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…2 ). The median age was 31.4 years (18–43) [ 2 , 14 , 19 , 22 , 28 , 32 , 36 , 39 , 43 ]. The gender distribution; 73.9% (311/421) of all patients were men and 26.1% (110/421) women [ 14 , 22 , 28 , 32 , 36 , 39 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…The gender distribution; 73.9% (311/421) of all patients were men and 26.1% (110/421) women [ 14 , 22 , 28 , 32 , 36 , 39 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…2 ). There were 769 autopsies after 33 separate mass shootings, including both pre- and in-hospital deaths [ 4 , 12 , 18 , 22 , 35 , 40 ]. However, three of these studies included the same events (Additional file 1 : Table S3).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of hemorrhage and vascular injuries in civilian public mass shootings

Nyberger

Strömmer

Wahlgren

2023

Scand J Trauma Resusc Emerg Med

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Background Civilian public mass shootings (CPMSs) are a major public health issue and in recent years several events have occurred worldwide. The aim of this systematic review was to characterize injuries and mortality after CPMSs focusing on in-hospital management of hemorrhage and vascular injuries. Method A systematic review of all published literature was undertaken in Medline, Embase and Web of Science January 1st, 1968, to February 22nd, 2021, according to the PRISMA guidelines. Literature was eligible for inclusion if the CPMS included three or more people shot, injured or killed, had vascular injuries or hemorrhage. Results The search identified 2884 studies; 34 were eligible for inclusion in the analysis. There were 2039 wounded in 45 CPMS events. The dominating anatomic injury location per event was the extremity followed by abdomen and chest. The median number of operations and operated patients per event was 22 (5–101) and 10.5 (4–138), respectively. A total of 899 deaths were reported with a median mortality rate of 36.1% per event (15.9–71.4%) Thirty-eight percent (13/34) of all studies reported on vascular injuries. Vascular injuries ranged from 8 to 29%; extremity vascular injury the most frequent. Specific vascular injuries included thoracic aorta 18% (42/232), carotid arteries 6% (14/232), and abdominal aorta 5% (12/232). Vascular injuries were involved in 8.3%-10% of all deaths. Conclusion This systematic review showed an overall high mortality after CPMS with injuries mainly located to the extremities, thorax and abdomen. About one quarter of deaths was related to hemorrhage involving central large vessel injuries. Further understanding of these injuries, and structured and uniform reporting of injuries and treatment protocols may help improve evaluation and management in the future. Level of Evidence Systematic review and meta-analysis, level III.

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Section: Resultsmentioning

confidence: 99%

“…The gender distribution; 73.9% (311/421) of all patients were men and 26.1% (110/421) women [ 14 , 22 , 28 , 32 , 36 , 39 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of hemorrhage and vascular injuries in civilian public mass shootings

Nyberger

Strömmer

Wahlgren

2023

Scand J Trauma Resusc Emerg Med

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“…Indeed, previous terror attacks have specifically targeted hospitals to increase deaths and decrease the healthcare system's ability to respond, so it is not inconceivable that an MTC could be the epicentre of an attack. 2 If that were the case, non-MTC hospitals need to have the ability to cope not only with a sudden influx of patients from the incident but also support the ‘normal’ workload of the MTC during the recovery phase of the disturbance. The Royal College of Surgeons of England stated in 2014 that it aspired to develop training for general and vascular surgeons to become competent in damage control and definitive trauma surgery.…”

Section: Clinical Versus Logistical Issuesmentioning

confidence: 99%

Training for major incidents

Porthouse¹,

Clancy²,

Lax³

2021

Surgery (Oxford)

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Major incidents are serious events with broad-reaching consequences that require extraordinary solutions to be implemented. They call for a team-based approach and efficient communication at all levels in addition to effective command, control and oversight. While consolidation of care into major trauma centres has led to improved outcomes for patients, it also means that clinicians may miss out on real-life experience of major incident or severe trauma casualties. It is therefore important to factor training, exercises and planning into individual and organizational preparedness. While several recent major incidents have occurred and provided further experience and lessons, such as the Grenfell Fire, Manchester Arena bombings and London Bridge stabbings, the global COVID-19 pandemic has required clinicians and organizations around the world to re-examine major incidents and the extent of their impacts. This has reinforced the importance of all members of the clinical team possessing an appropriate level of awareness and understanding of major incidents.

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“…10 Our security team secured the ED by blocking any nonessential personnel from entering the ED and by performing security screens on those deemed admissible. The minutes between notification of a disaster and first patient arrival are crucial to begin formulating a care plan.…”

Section: Existing Bidmc Framework Personnel Trainingmentioning

confidence: 99%

Lessons From the Boston Marathon Bombing

Tobert

Keudell

Rodriguez

2015

Journal of Orthopaedic Trauma

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The 2013 Boston Marathon bombing resulted in a mass casualty event that tested the limits of Boston-area trauma centers. The explosions, 12 seconds apart, led to the rapid influx of 124 patients with primarily lower extremity injuries in 5 different adult level 1 trauma centers. This study aimed to examine the existing hospital systems in place for disaster scenarios at the time of the event and identify areas for improvement. Preparation before the Boston Marathon bombing included coordinating the delivery of patients to area facilities and creating a framework for response at an institutional level. These simulations, coupled with the fact that the explosions occurred at a nexus of medical facilities, helped provide impactful care preventing any fatalities in patients who arrived at a Boston hospital that day. The experience at our institution led to the implementation of a more robust communication infrastructure and reinforced the value of preparatory drills. Within the Orthopaedic Surgery Department, we developed a more robust organizational hierarchy for mass casualty events and implemented a multitrauma follow-up clinic. We believe that it is the responsibility of every hospital to have systems in place to handle the rapid arrival of patients with multiple-trauma, and we hope that others can learn from our experience.

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Mortality pattern of the 26/11 Mumbai terror attacks

Abstract: V, epidemiological study.

Cited by 10 publications

References 10 publications

A systematic review of hemorrhage and vascular injuries in civilian public mass shootings

A systematic review of hemorrhage and vascular injuries in civilian public mass shootings

Training for major incidents

Lessons From the Boston Marathon Bombing

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