Earthquake Related Injuries: Assessment of 854 Victims of the 2003 Bam Disaster Transported to Tertiary Referral Hospitals

Background: In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed >90% of the city. After the assessment and initial treatment of injuries at national and international field hospitals, a considerable number of victims (approximately 12,000) were transferred to tertiary referral hospitals around the country. Objective: This report evaluated the injuries of 854 victims transferred to 12 referral hospitals in Tehran. Methods: The demographic data, injury patterns, injury severity score (ISS), diagnosis, treatment, and outcome data of 854 Bam earthquake victims were assessed. Results: There were 467 (54.7%) males and 387 (45.3%) females. The mean age of the patients was 29.0 years. Transportation by aircraft was the most common method used for evacuation, which was used to evacuate 555 patients (65%). Fifty-four percent of the victims required initial medical aid at field hospitals before transportation to Tehran. There were 1,322 patients with injuries, of which, fractures of the lower extremities were the most common (331; 25%). Limb fixation was the most commonly performed primary procedure in emergency wards (389 cases, 39.9%). The mean value +/- SD for ISS was 6.7 +/- 5.2. Orthopedic operations were the most frequent surgical procedures performed (195/260 operations, 75%) and the overall mortality rate was 1.6% (n = 14). Conclusions: Along with the crucial importance of aid provided by national and international field hospitals in disasters, suitable triage of casualties and preparedness of tertiary referral centers in unaffected regions also play an important role in providing medical care to disaster victims. During these situations, the number of victims cannot be predicted accurately, and sufficient medical care, particularly for orthopedic problems, can be provided by referral centers.