Epidemiology of Blast Neurotrauma: A Meta-analysis of Blast Injury Patterns in the Military and Civilian Populations

BACKGROUND: Mass casualty incidents (MCIs) due to bombing-related terrorism remain an omnipresent threat to our global society. The aim of this study was to elucidate differences in blast injury patterns between military and civilian victims affected by terrorist bombings. METHODS: An analysis of the Global Terrorism Database (GTD) and a PubMed literature search of casualty reports of bombing attacks from 2010-2020 was performed (main key words: blast injuries/therapy, terrorism, military personnel) with key epidemiological and injury pattern data extracted and statistically analyzed. RESULTS: Demographic analysis of casualties revealed that military casualties tend to be younger and predominantly male (P < 0.05) compared with civilians. Military casualties also reported higher amounts of head/neck injury (P < 0.01) compared with civilians. The proportion of instantaneous fatalities along with injuries affecting the thoracolumbar and extremity regions remained approximately equal across both groups. CONCLUSIONS: Though the increased number of head/neck injuries was unexpected, we also found that the number of nonlethal head injuries also increased, predicating that more military blast neurotrauma patients survived their injuries. These data can be used to increase blast MCI preparation and education throughout the international neurosurgical community.

Automated summary

Mass casualty incidents due to bombing-related terrorism pose a significant threat to global society. A study compared blast injury patterns between military and civilian victims of terrorist bombings, finding differences in demographics and injury distribution. Military casualties were younger, predominantly male, and reported higher rates of head/neck injuries compared to civilians, while both groups had similar rates of instantaneous fatalities and injuries to the chest, lumbar spine, and extremities.