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Military thoracic gunshot wounds: A systematic review

Amy Pullen
Amy Pullen
, 
David Kieser
David Kieser
 oraz 
Gary Hooper
Gary Hooper
   | 01 paź 2021
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Article Category: Original study
Data publikacji: 01 paź 2021
Zakres stron: 118 - 129
Otrzymano: 05 lip 2020
Przyjęty: 10 lip 2021
DOI: https://doi.org/10.2478/jms-2021-0009
Słowa kluczowe
© 2021 Amy Pullen et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

PRISMA flow diagram.
PRISMA flow diagram.

Fig. 2

Frequency of thoracic gunshot injuries per month and percentage of fatalities from thoracic GSW for studies with a low risk of bias.
Frequency of thoracic gunshot injuries per month and percentage of fatalities from thoracic GSW for studies with a low risk of bias.

Fig. 3

Frequency of thoracic gunshot injuries per month and percentage of fatalities from thoracic GSW for studies with a low and unclear risk of bias.
Frequency of thoracic gunshot injuries per month and percentage of fatalities from thoracic GSW for studies with a low and unclear risk of bias.

Risk of bias assessment using a modified Cochrane Tool

Study ID Allocation concealment (Selection bias) Assessment of exposure (Performance bias) Outcome of interest present at beginning (detection bias) Incomplete data (attrition bias) Selective reporting (reporting bias) Total score*
(Herget et al. 1962) + + + ? ? 3
(Hopkins 1962) + + + + ? 4
(Oughterson et al. 1962) + + + ? ? 3
(Tribby 1962) + + + ? ? 3
(McNamara et al. 1970) + + + ? ? 3
(Boyd 1975) + + + + ? 4
(Moffat 1976) + + + + ? 4
(Mabry et al. 2000) + + + ? ? 3
(Brady 2003) + + + ? ? 3
(Kosashvili et al. 2005) + + + ? ? 3
(Hinsley et al. 2005) − + + ? ? 2
(Lewis 2006) + + + ? ? 3
(Zouris et al. 2006) + + + ? ? 3
(Owens et al. 2008) + + + ? ? 3
(Ramasamy et al. 2009) + + + ? ? 3
(Belmont Jr et al. 2010) + + + ? ? 3
(Poon et al. 2013) + + + ? ? 3
(Popivanov et al. 2014) − + + ? ? 2
(Martin 2015) + + + ? ? 3
(Lesquen et al. 2016) − + + ? ? 2
(Penn-Barwell et al. 2016) − + + + ? 3
(Stevenson et al. 2018) + + + + ? 4
(Schauer et al. 2019) + + + ? ? 3

Details of studies identified, thoracic GSW and fatalities

Reference Quality rating/Risk of bias Operational theatre Period Population No of thoracic GSW % of thoracic wounds that GSW accounted for % of GSW that thorax accounted for Number/% of fatalities from thoracic GSW % of fatalities from thoracic GSW Remarks
(Oughterson et al. 1962) Fair/Unclear Bougainville 15 Feb–21 Apr 1944 US Army Ground forces 85 40 Accounted for 59.7% of deaths.
(Hopkins 1962) Good/Low New Georgia – Burma Feb–June 1944 1st and 3rd battalion, 5307th Composite unit 63 17 32 50.7
(Tribby 1962) Good/Unclear Italy 1944 1000 American Casualties KIA 32 Thoracic GSW accounted for 9% of all deaths
(Herget et al. 1962) Fair/Unclear Korea 15 Nov 1950–5 May 1951 US Army 37 6
(Brady 2003) Good/Unclear Vietnam July 1967 – June 1969 US Army 51%
(McNamara et al. 1970) Fair/Unclear Vietnam Sept 1968–Nov 1969 All Nationalities 76 14
(Boyd 1975) Good/Low Belfast 1972–1974 Not detailed 91 43 47.3
(Moffat 1976) Good/Low Northern Ireland 1971–1974 British Serviceman 118 17 48 40.7
(Mabry et al. 2000) Fair/Unclear Somalia 3–4 Oct 1993 United States Army Ranger 2 5
(Kosashvili et al. 2005) Fair/Unclear Israel Mar 2002–Apr 2002 Israeli defence force 32 44 Kevlar body armour
(Hinsley et al. 2005) Poor/High Iraq 21 March and 4 April 2003, Casualties treated at 202 field hospital 3 10 May include civilians
(Zouris et al. 2006) Fair/Unclear Iraq Mar 23–Apr 30 2003 US marines and sailors 8.5
(Owens et al. 2008) Fair/Unclear Iraq and Afghanistan Oct 2001–Jan 2005 US service members 19
(Ramasamy et al. 2009) Fair/Unclear Iraq Jan–Oct 2006 Iraq 3
(Lewis 2006) Good/Unclear Iraq Operation Telic–2006 UK Military 7
(Martin 2015)1 Poor/Unclear All theatres 2001–2009 Casualties in JTTR
(Popivanov et al. 2014) Poor/High Afghanistan 2010 Casualties presenting to Bulgarian Military hospital 16 29 May include civilians
(Belmont et al. 2010) Fair/Unclear Iraq Iraq surge phase US Army Brigade Combat Team, 1.3
(Poon et al. 2013) Fair/Unclear Iraq and Afghanistan Mar 2003–Mar 2011 UK Military 320 38.7 49 15.3
(Penn-Barwell et al. 2016) Good/Unclear All Active theatres Jan 2009–31 Dec 2013 UK Military 402 23 269 31
(Stevenson et al. 2018) Good/Low Iraq and Afghanistan 2003–2014 UK military 106 15 22 48 27
(Schauer et al. 2019) Poor/Unclear Iraq and Afghanistan January 2007 to August 2016. Casualties presenting to military emergency departments 1087 16.3 May include civilians
(Lesquen et al. 2016) Poor/High Afghanistan 2009–2016 Casualties admitted to French NATO combat support hospital 47 53 May include civilians

Criteria for the modified Newcastle-Ottawa Scale regarding star allocation to assess quality of studies

Criteria Acceptable (star awarded) Unacceptable (star not awarded)
Representativeness of exposed cohort (*) Population based Hospital based
Civilians included
Ascertainment of exposure (*) Trauma records Anecdotal evidence
Comparability (**) ** awarded for both number of casualties and number of fatalities comparable No metrics comparable
* awarded for only one metric comparable
Assessment of outcome (*) Trauma records No outcome data

Quality assessment of studies using a modified Newcastle Ottawa Scale for assessing studies in the systematic review of military thoracic gunshot injuries

Study ID Selection Comparability Outcome Total score (5*)
Representativeness of exposed cohort (*) Ascertainment of exposure (*) (**) Assessment of outcome(*)
(Herget et al. 1962) * * * 3
(Hopkins 1962) * * ** * 5
(Oughterson et al. 1962) * * * 3
(Tribby 1962) * * ** * 5
(McNamara et al. 1970) * * * 3
(Boyd 1975) * * ** * 5
(Moffat 1976) * * ** * 5
(Mabry et al. 2000) * * * 3
(Brady 2003) * * * * 4
(Kosashvili et al. 2005) * * * 3
(Hinsley et al. 2005) * * 2
(Lewis 2006) * * ** * 5
(Zouris et al. 2006) * * * 3
(Owens et al. 2008) * * * 3
(Ramasamy et al. 2009) * * * 3
(Belmont Jr et al. 2010) * * * 3
(Poon et al. 2013) * * * 3
(Popivanov et al. 2014) * * 2
(Martin 2015) * * 2
(Lesquen et al. 2016) * * 2
(Penn-Barwell et al. 2016) * * ** * 5
(Stevenson et al. 2018) * * ** * 5
(Schauer et al. 2019) * * 2
eISSN:
1799-3350
Język:
Angielski
Częstotliwość wydawania:
Volume Open
Dziedziny czasopisma:
History, Topics in History, Military History, Social Sciences, Political Science, Military Policy
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