Injury morbidity and mortality during conflict: evidence from the 2024 war on lebanon

Wars and armed conflicts have long-lasting and devastating impacts on populations and health systems in low- and middle-income countries (LMICs). The 2024 Israeli military operations in Lebanon occurred amid an already fragile socioeconomic and healthcare landscape. This study provides the first nationally representative analysis of war-related injuries and deaths in Lebanon, offering critical insight into the health consequences of modern conflict.

A multicenter retrospective observational study was conducted using data from 149 hospitals across Lebanon from October 2023 to March 2025. Mortality data were obtained from the National Hospital Mortality System (NHMS), while morbidity data were sourced from the Ministry of Public Health (MoPH)-subsidized hospitals. Injury-related cases were identified using relevant ICD-10 codes. Descriptive and bivariate analyses were performed to assess associations between demographic, geographic, clinical, and injury-related variables, and outcomes.

A total of 21,853 individuals were included, with 80.45% sustaining injuries and 19.55% recorded as fatalities. The most affected age group was 40-44 years (38.65%), and males accounted for 81.09% of cases. Lebanese nationals comprised 90.08% of the affected. The South and Nabatiyeh governorates reported the highest injury and fatality rates. The leading mechanisms of injury were blast injuries (29.79%) and gunshots (14.04%). Of those injured, 51.9% were discharged from the emergency department, 40.86% were admitted, and 7.24% required ICU care. Among fatalities, 81.46% were dead on arrival. Bivariate analysis showed significant associations between incident status (dead/injured) and age, sex, nationality, hospital type, geographic region, and mechanism of injury (all p < 0.001).

The study highlights the immense human toll of the 2024 conflict in Lebanon on a population already crippled with economic crises and a fragile healthcare system. While vulnerable populations including women and children were heavily impacted, many blast victims were reported dead before hospital arrival due to limited access to timely care and the targeting of healthcare infrastructure. The findings underscore the violations of international humanitarian law and highlight the urgent need to protect civilians and healthcare infrastructure, as well as to strengthen emergency preparedness and post-conflict recovery.