Reduction of Mortality Rate in Mine Victims: Four Year Interventional Prospective Study in Eyllam Province of I.R. Iran

Low-tech and low-cost prehospital trauma programs improve trauma care in rural I.R. Iran. Compared to historical control, the intervention significantly reduced mortality rate in land mine victims. In the rural clinics 109 health workers had been trained on advanced life support procedures including practice on animal models. At village level 4'725 lay people were trained in basic life support as first helpers. The system managed 288 casualties with penetrating mine injuries. The median ISS (Injury Severity Score) of the study population was 20.37, there were 40% major trauma victims (ISS >15). The overall mortality in the 4 year study period was 27%. The physiological condition was described by Physiologic Severity Score (PSS) PSS in-field was 6.409 and comparing to hospital admission PSS (7.43), it was significantly improved in most trauma victims [CI of difference 95%, (-1.172 – - 0.980)]. An intervention study of prehospital and emergency trauma care was carried out. Health personnel at rural clinics and layman villagers were trained and equipped for trauma care. Prehospital medical data were gathered on mine injured from 2002 to 2005 (n = 288). Outcome indicators (treatment impact on physiological severity and trauma mortality) were gathered at one referral surgical center. A previous survey reported high mortality rate in land mine accidents in Eylam, I.R. Iran (36.4%). Responding to the survey, the actual intervention aimed at reducing land mine mortality by setting up a rural trauma system in land mine infested areas of Eylam.