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Pediatric Surgical Care in a Dutch Military Hospital in Afghanistan.

Idenburg FJ, van Dongen TT, Tan EC, Hamming JH, Leenen LP, Hoencamp R - World J Surg (2015)

Bottom Line: Because these experiences could be influential in future mission planning, we analyzed our data and compared them with international reports.Girls were significantly younger of age than boys.In-hospital mortality was 5.3 %.

View Article: PubMed Central - PubMed

Affiliation: Royal Netherlands Navy (R) and Division of Surgery, Department of Trauma Surgery, MC Haaglanden - Bronovo, Lijnbaan 32, 2512 VA, Den Haag, The Netherlands, f.idenburg@mchaaglanden.nl.

ABSTRACT

Background: From August 2006-August 2010, as part of the ISAF mission, the Armed Forces of the Netherlands deployed a role 2 enhanced Medical Treatment Facility (R2E-MTF) to Uruzgan province, Afghanistan. Although from the principle doctrine not considered a primary task, care was delivered to civilians, including many children. Humanitarian aid accounted for a substantial part of the workload, necessitating medical, infrastructural, and logistical adaptations. Particularly pediatric care demanded specific expertise and equipment. In our pre-deployment preparations this aspect had been undervalued. Because these experiences could be influential in future mission planning, we analyzed our data and compared them with international reports.

Methods: This is a retrospective, descriptive study. Using the hospital's electronic database, all pediatric cases, defined as patients <17 years of age, who were admitted between August 2006 and August 2010 to the Dutch R2E-MTF at Multinational Base Tarin Kowt (MBTK), Urzugan, Afghanistan were analyzed.

Results: Of the 2736 admissions, 415 (15.2 %) were pediatric. The majority (80.9 %, 336/415) of these admissions were for surgical, often trauma-related, pathology and required 610 surgical procedures, being 26 % of all procedures. Mean length of stay was 3.1 days. The male to female ratio was 70:30. Girls were significantly younger of age than boys. In-hospital mortality was 5.3 %.

Conclusion: Pediatric patients made up a considerable part of the workload at the Dutch R2E-MTF in Uruzgan, Afghanistan. This is in line with other reports from the recent conflicts in Iraq and Afghanistan, but used definitions in reported series are inconsistent, making comparisons difficult. Our findings stress the need for a comprehensive, prospective, and coalition-wide patient registry with uniformly applied criteria. Civilian disaster and military operational planners should incorporate reported patient statistics in manning documents, future courses, training manuals, logistic planning, and doctrines, because pediatric care is a reality that cannot be ignored.

No MeSH data available.


Distribution of pediatric admissions in age and sex (n = 415)
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Related In: Results  -  Collection


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Fig1: Distribution of pediatric admissions in age and sex (n = 415)

Mentions: Of the admitted infants and children, 288 (69.4 %) were male and 76 (18.3 %) were female (p < 0.05). In 51 cases (12.3 %), we could not find sex documented. The age and sex distribution of the pediatric cases are represented in Fig. 1; the youngest child was 6 months of age. This pediatric population was registered as disease and non-battle injury (DNBI), and the delivered care considered humanitarian aid.Fig. 1


Pediatric Surgical Care in a Dutch Military Hospital in Afghanistan.

Idenburg FJ, van Dongen TT, Tan EC, Hamming JH, Leenen LP, Hoencamp R - World J Surg (2015)

Distribution of pediatric admissions in age and sex (n = 415)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554739&req=5

Fig1: Distribution of pediatric admissions in age and sex (n = 415)
Mentions: Of the admitted infants and children, 288 (69.4 %) were male and 76 (18.3 %) were female (p < 0.05). In 51 cases (12.3 %), we could not find sex documented. The age and sex distribution of the pediatric cases are represented in Fig. 1; the youngest child was 6 months of age. This pediatric population was registered as disease and non-battle injury (DNBI), and the delivered care considered humanitarian aid.Fig. 1

Bottom Line: Because these experiences could be influential in future mission planning, we analyzed our data and compared them with international reports.Girls were significantly younger of age than boys.In-hospital mortality was 5.3 %.

View Article: PubMed Central - PubMed

Affiliation: Royal Netherlands Navy (R) and Division of Surgery, Department of Trauma Surgery, MC Haaglanden - Bronovo, Lijnbaan 32, 2512 VA, Den Haag, The Netherlands, f.idenburg@mchaaglanden.nl.

ABSTRACT

Background: From August 2006-August 2010, as part of the ISAF mission, the Armed Forces of the Netherlands deployed a role 2 enhanced Medical Treatment Facility (R2E-MTF) to Uruzgan province, Afghanistan. Although from the principle doctrine not considered a primary task, care was delivered to civilians, including many children. Humanitarian aid accounted for a substantial part of the workload, necessitating medical, infrastructural, and logistical adaptations. Particularly pediatric care demanded specific expertise and equipment. In our pre-deployment preparations this aspect had been undervalued. Because these experiences could be influential in future mission planning, we analyzed our data and compared them with international reports.

Methods: This is a retrospective, descriptive study. Using the hospital's electronic database, all pediatric cases, defined as patients <17 years of age, who were admitted between August 2006 and August 2010 to the Dutch R2E-MTF at Multinational Base Tarin Kowt (MBTK), Urzugan, Afghanistan were analyzed.

Results: Of the 2736 admissions, 415 (15.2 %) were pediatric. The majority (80.9 %, 336/415) of these admissions were for surgical, often trauma-related, pathology and required 610 surgical procedures, being 26 % of all procedures. Mean length of stay was 3.1 days. The male to female ratio was 70:30. Girls were significantly younger of age than boys. In-hospital mortality was 5.3 %.

Conclusion: Pediatric patients made up a considerable part of the workload at the Dutch R2E-MTF in Uruzgan, Afghanistan. This is in line with other reports from the recent conflicts in Iraq and Afghanistan, but used definitions in reported series are inconsistent, making comparisons difficult. Our findings stress the need for a comprehensive, prospective, and coalition-wide patient registry with uniformly applied criteria. Civilian disaster and military operational planners should incorporate reported patient statistics in manning documents, future courses, training manuals, logistic planning, and doctrines, because pediatric care is a reality that cannot be ignored.

No MeSH data available.