Risk factors associated with mortality from explosions in civilian and military populations

Trauma from explosions is among the most serious injuries faced by healthcare professionals. There are few studies that describe the risk factors for mortality, or the patterns of blast injuries in the civilian compared to the military population. Review of articles extracted from Medline, PubMed, and Scopus published (01/2014-03/2024). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Data on mortality and injury patterns were extracted from the articles that met the inclusion criteria to describe the type of injuries and to identify risk factors for mortality. Sixteen articles were included. Average age of civilians was 40.0 years ± 3.7, with men representing 79.4% compared to a mean age of 24.5 ± 1.4 and 79.0% for the military patients. While there was no difference in the distribution of injuries by body regions, the civilian population was more likely to sustain severe cranial and thoracic injuries (31.9% and 20.4% vs. 18.1% and 9.9%, respectively). Civilian population had a non-statistically significant lower risk of death (odds ratio = 0.96; 95% confidence interval = 0.82, 1.13). The findings of this review indicate that clinical experience derived from explosions occurring in one setting may not be fully generalizable to explosions occurring in other contexts, as demographic, environmental, and contextual factors contribute to distinct injury patterns.