@article{ref1,
title="Terror in Paris: incidence and risk factors for infections related to high-energy ammunition injuries",
journal="Anaesthesia, critical care and pain medicine",
year="2021",
author="Birnbaum, Ron and Bitton, Rudy and Pirracchio, Romain and Feral-Pierssens, Anne-Laure and Constant, Anne-Laure and Dubost, Clément and Chousterman, Benjamin and Lescot, Thomas and Lortat-Jacob, Brice and Harrois, Anatole and Abback, Paër-Sélim and Belbachir, Anissa and Basto, Emmanuel and Castier, Yves and Laitselart, Philippe and Carli, Pierre and Lapostolle, Frederic and Tourtier, Jean Pierre and Langlois, Matthieu and Raux, Mathieu and Mounier, Roman",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: We aimed to assess the incidence and the risk factors for secondary wound infections associated to high-energy ammunition injuries (HEAI) in the cohort of civilian casualties from the 2015 terrorist attacks in Paris. <br><br>METHODS: This retrospective multi-centric study included casualties presenting at least one HEAI who underwent surgery during the first 48 hours following hospital admission. HEAI associated infection was defined as a wound infection occurring within the initial 30 days following trauma. Risk factors were assessed using univariate and multivariate analysis. <br><br>RESULTS: Among the 200 included victims, the rate of infected wounds was 11.5%. The median time between admission and the surgical revision for secondary wound infection was 11 days [9-20]. No patient died from an infectious cause. Infections were poly-microbial in 44 % of the cases. The major risk factors for secondary wound infection were ISS (p < 0.001), SAPS II (p < 0.001), MGAP (p < 0.001), haemorrhagic shock (p = 0.003), use of vasopressors (p < 0.001), blood transfusion (p < 0.001), abdominal penetrating trauma (p = 0.003), open fracture (p = 0.01), vascular injury (p = 0.001), duration of surgery (p = 0.009), presence of surgical material (p =  0.01). In the multivariate analysis, the SAPS II score (OR 1.07 [1.014-1.182], p = 0.019) and the duration of surgery (OR 1.005 [1.000-1.012], p = 0.041) were the only risk factors identified. <br><br>CONCLUSION: We report an 11.5% rate of secondary wound infection following high-energy ammunition injuries. Risk factors were an immediately severe condition and a prolonged surgery.<p /> <p>Language: en</p>",
language="en",
issn="2352-5568",
doi="10.1016/j.accpm.2021.100908",
url="http://dx.doi.org/10.1016/j.accpm.2021.100908"
}