TY  - JOUR
PY  - 2021//
TI  - Terror in Paris: incidence and risk factors for infections related to high-energy ammunition injuries
JO  - Anaesthesia, critical care and pain medicine
A1  - Birnbaum, Ron
A1  - Bitton, Rudy
A1  - Pirracchio, Romain
A1  - Feral-Pierssens, Anne-Laure
A1  - Constant, Anne-Laure
A1  - Dubost, Clément
A1  - Chousterman, Benjamin
A1  - Lescot, Thomas
A1  - Lortat-Jacob, Brice
A1  - Harrois, Anatole
A1  - Abback, Paër-Sélim
A1  - Belbachir, Anissa
A1  - Basto, Emmanuel
A1  - Castier, Yves
A1  - Laitselart, Philippe
A1  - Carli, Pierre
A1  - Lapostolle, Frederic
A1  - Tourtier, Jean Pierre
A1  - Langlois, Matthieu
A1  - Raux, Mathieu
A1  - Mounier, Roman
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 2352-5568
UR  - http://dx.doi.org/10.1016/j.accpm.2021.100908
ID  - ref1
ER  -