Terrorist attacks in Paris: Surgical trauma experience in a referral center

Thomas M Gregory; Thomas Bihel; Pierre Guigui; Jérôme Pierrart; Benjamin Bouyer; Baptiste Magrino; Damien Delgrande; Thibault Lafosse; Jaber Al Khaili; Antoine Baldacci; Guillaume Lonjon; Sébastien Moreau; Laurent Lantieri; Jean-Marc Alsac; Jean-Baptiste Dufourcq; Jean Mantz; Philippe Juvin; Philippe Halimi; Richard Douard; Olivier Mir; Emmanuel Masmejean

doi:10.1016/j.injury.2016.08.014

Terrorist attacks in Paris: Surgical trauma experience in a referral center

Injury. 2016 Oct;47(10):2122-2126. doi: 10.1016/j.injury.2016.08.014. Epub 2016 Aug 24.

Authors

Thomas M Gregory¹, Thomas Bihel², Pierre Guigui³, Jérôme Pierrart², Benjamin Bouyer³, Baptiste Magrino³, Damien Delgrande², Thibault Lafosse², Jaber Al Khaili², Antoine Baldacci⁴, Guillaume Lonjon³, Sébastien Moreau³, Laurent Lantieri⁵, Jean-Marc Alsac⁶, Jean-Baptiste Dufourcq⁷, Jean Mantz⁷, Philippe Juvin⁸, Philippe Halimi⁹, Richard Douard¹⁰, Olivier Mir¹¹, Emmanuel Masmejean²

Affiliations

¹ Upper limb and Peripheral nerve Unit, Department of Traumatology and Orthopaedic Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France. Electronic address: tms.gregory@gmail.com.
² Upper limb and Peripheral nerve Unit, Department of Traumatology and Orthopaedic Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
³ Spine surgery and General Orthopaedics Unit, Department of Traumatology and Orthopaedic Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
⁴ Upper limb and Peripheral nerve Unit, Department of Traumatology and Orthopaedic Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France; Spine surgery and General Orthopaedics Unit, Department of Traumatology and Orthopaedic Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
⁵ Department of Plastic and Reconstructive Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
⁶ Department of Vascular Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
⁷ Department of Anaesthesiology, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
⁸ Department of Emergency Medicine, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
⁹ Department of Imaging, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
¹⁰ Department of Visceral Surgery, Teaching European Hospital Georges Pompidou, Assistance Publique - Hôpitaux de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
¹¹ MOVEO Institute, University Paris Descartes, Sorbonne Paris Cité, Paris, France.

PMID: 27578051
DOI: 10.1016/j.injury.2016.08.014

Abstract

Background: On November 13th, 2015, terrorist bomb explosions and gunshots occurred in Paris, France, with 129 people immediately killed, and more than 300 being injured. This article describes the staff organization, surgical management, and patterns of injuries in casualties who were referred to the Teaching European Hospital Georges Pompidou.

Methods: This study is a retrospective analysis of the pre-hospital response and the in-hospital response in our referral trauma center. Data for patient flow, resource use, patterns of injuries and outcomes were obtained by the review of electronic hospital records.

Results: Forty-one patients were referred to our center, and 22 requiring surgery were hospitalized for>24h. From November 14th at 0:41 A.M. to November 15th at 1:10 A.M., 23 surgical interventions were performed on 22 casualties. Gunshot injuries and/or shrapnel wounds were found in 45%, fractures in 45%, head trauma in 4.5%, and abdominal injuries in 14%. Soft-tissue and musculoskeletal injuries predominated in 77% of cases, peripheral nerve injury was identified in 30%. The mortality rate was 0% at last follow up.

Conclusion: Rapid staff and logistical response, immediate access to operating rooms, and multidisciplinary surgical care delivery led to excellent short-term outcomes, with no in-hospital death and only one patient being still hospitalized 45days after the initial event.

Keywords: Injury; Perihperal nerve surgery; Trauma: gunshot; Upper limb surgery.

MeSH terms

Adult
Blast Injuries / therapy*
Critical Care / organization & administration*
Critical Care / standards
Efficiency, Organizational / standards*
Emergency Service, Hospital / organization & administration*
Emergency Service, Hospital / standards
Explosions
Female
Humans
Injury Severity Score
Male
Middle Aged
Paris
Retrospective Studies
Terrorism*
Trauma Centers / organization & administration*
Trauma Centers / standards
Wounds and Injuries / therapy*
Young Adult