In Afghanistan, noncombat-related admissions were over twice the number of combat-related admissions (2,197 vs. 1,095). In Iraq, it was almost equal (1,391 vs. 1,590). "In Afghanistan, the difference was pretty striking," Dr. Edwards said. "Every single year it was mostly noncombat-related diagnoses that brought these kids in."
The study found that older children were more likely to be combat victims, and the death rate was highest for children admitted for combat-related trauma in Iraq (11 percent) and noncombat-related trauma in Afghanistan (8 percent). The in-hospital mortality rate in both Iraq and Afghanistan was 5 percent for admissions unrelated to trauma.
"When we looked at the surgical admissions of the non-trauma patients, for instance having an appendix out, the mortality was less than 1 percent. But mortality for the medical admissions, such as pneumonia or seizures, for example, was 10 percent," Dr. Edwards said. "So the kids who came in with just medical problems are the ones who needed a lot of resources and really didn't fare as well."
Although Iraq had a robust medical structure in place prior to the conflict, the system fell apart during wartime. "When the conflict arose, hospitals were looted and care was disrupted," Dr. Edwards said. In Afghanistan, medical resources were lacking. "I took care of kids whose families walked days just to get a chance to be seen at the military hospital."
Dr. Edwards hopes that these findings will help health care workers worldwide better preparewith training, equipment and medical teams with pediatric specialiststo treat injured and sick childrenpatients who might otherwise die in these war zones.
|Contact: Sally Garneski|
American College of Surgeons