Clinical and epidemiological characteristics of the chest gunshot wounds among servicemen during ATO/JFO

Keywords: gunshot wounds of the chest, damage of anatomical and functional areas

Abstract

Introduction. Gunshot wounds of the chest during the ATO/JFO were 7.4 - 11.7%. At the same time, the mortality rate remains quite high - 12.2 - 25%. The severity of the wound, surgical tactics and the outcome of treatment depends from ballistic and anatomical and morphological characteristics. Therefore, conducting a clinical and epidemiological investigation of the chest wounds in servicemen during the ATO/JFO will allow to choose adequate diagnostic and treatment tactics and calculate the necessary forces and means of medical service.

The purpose. To conduct a clinical and epidemiological investigation of gunshot wounds of the chest during ATO/JFO and identify factors that affect the severity of injury.

Materials and methods. An analysis of the treatment of 536 wounded with gunshot wounds of the chest, who were in the MMCC of the Northern region (Kharkiv), the National Military Medical Clinical Center (Kyiv) during the combat actions in the  Eastern Ukraine from 2014 to 2016 years.

Results. In the structure of the chest gunshot wounds were dominated fragments – 387 (72,2%). Explosive wounds were founded in 94 (17,5%) injured, bullet wounds in the 55 (10,3%). Among fragments wounds, the share of non-penetrating was the largest - 80.9% (n = 313), while among explosive and bullet - penetrating prevailed: 62.8% (n = 59) and 61.5% (n = 34), respectively. In penetrating injuries, damage of the internal organs occurred in ¾ patients. The largest share of wounded with severe injuries was among bullet wounds - 50.9% (n = 28); among explosive and fragments wounds: 26.6% (n = 25) and 23.8% (n = 92), respectively. Based on multivariate logistic regression analysis, it was found that the character of the wound "bullet" (Wald = 14.1; p = 0.00), combined (Wald = 4.67; p = 0.03) and penetrating character (Wald = 7, 94; p = 0.005) are independent risk factors for serious injury.

Conclusions. During the ATO/JFO, fragments wounds of the chest accounted for 72.2%; they were mostly multiple - 77.8%, but the proportion of severe - 23.8% and penetrating - 19.1% of wounds among them is relatively small. Bullet wounds occurred in 10.3%; they had a high probability of penetrating nature - 61.5%, and serious injury - 50.9%. Explosive wounds conditionally occupied an intermediate position: their share - 17.5%; penetrating and severe of them: 62.8% and 26.6%, respectively.

Author Biographies

Ya. L. Zarutskiy, Ukrainian military medical academy

MD, DSci, Professor, Chief of Department of Military Surgery

A. Ye. Tkachenko, Ukrainian military medical academy

LtC MS, PhD, Senior lecturer of the Department of Military Surgery

M. S. Vovk , Ukrainian military medical academy

Ct MS, Adjunct of the Department of Military Surgery

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Published
2021-04-19
How to Cite
Zarutskiy, Y. L., Tkachenko, A. Y., & Vovk , M. S. (2021). Clinical and epidemiological characteristics of the chest gunshot wounds among servicemen during ATO/JFO. Ukrainian Journal of Military Medicine, 2(1), 87-93. https://doi.org/10.46847/ujmm.2021.1(2)-087
Section
Current aspects of diagnosis and treatment