Impact of the terrorist bombings of the Neve Shalom and Beth Israel synagogues on a hospital in Istanbul, Turkey

Objectives: The authors sought to estimate the impact of the open-air mass-casualty terrorist bombings of the Neve Shalom and Beth Israel Synagogues in Istanbul, Turkey, on November 15, 2003, on the American Hospital (AH) in terms of resource utilization, epidemiologic outcomes, and time course of emergency needs. Methods: A retrospective descriptive study using data from hospital records of injured survivors who used the emergency department at AH on November 15, 2003, to determine the number and percentage of injured survivors who were hospitalized, received operative care, had specific injury types, had an Injury Severity Score 16, died, and arrived within certain time intervals. Results: AH received 69 (91 %) injured survivors from the scene, of which nine (12 %) were hospitalized and three (4 %) received operative care. Starting four hours after the initial blast, seven (9 %) injured survivors were transferred to AH from other hospitals, of which five (7 %) were hospitalized and four (5 %) received operative care. Of the 49 injured survivors from the scene with documented injuries, 43 (88 %) had injuries to the head or face, 42 (86 %) had lacerations, five (10 %) had fractures, one (2 %) had a penetrating eye injury, one (2%) had a serious intracranial injury, and none had primary blast injuries. Four (5 %) injured survivors at AH had an Injury Severity Score greater than or equal to 16, and none died. Conclusions: Seventy-six injured survivors used the emergency department at AH, including a delayed wave of injured survivors transferred from other hospitals. The majority of injured survivors with documented injuries had non-life-threatening lacerations of the head or face, and relatively few injured survivors were hospitalized or received operative care