Impact of the terrorist bombings of the Hong Kong Shanghai Bank Corporation headquarters and the British Consulate on two hospitals in Istanbul, Turkey, in November 2003

Abstract

Background: The authors sought to estimate the impact of the terrorist bombings of the Hong Kong Shanghai Banking Corporation headquarters and the British consulate in Istanbul, Turkey, on November 20, 2003, on two nearby hospitals, in terms of epidemiologic outcomes, resource utilization, and time course of emergency needs.

Methods: The authors used data from hospital records of injured survivors who used the emergency departments (EDs) at the Taksim Education and Research State Hospital (TERSH) and the American Hospital (AH) in Istanbul on November 20, 2003, to determine the totals and rates of mortality (early, late, and critical), injury, critical injury (Injury Severity Score > 15), ED use, hospitalization, operative care, and in-hospital overtriage and the time intervals of ED arrival.

Results: The TERSH received 184 victims in the first hour after the initial blast, of which 88 (48%) were brought by emergency medical services, 171 (93%) had lacerations, 7 (4%) had penetrating eye injuries, 28 (15%) were hospitalized, 18 (10%) received operative care, and 7 (4%) were critically injured. Three deaths occurred in critically injured survivors, including one early death in the operating room and two late deaths on days 5 and 6. The AH received 16 victims, of which 14 (88%) had lacerations, 3 (19%) were hospitalized, 2 (13%) received operative care, and 1 (6%) was critically injured. An additional 4 victims were transferred to the AH from other hospitals, of which 3 were hospitalized and none were critically injured. No early or late deaths occurred.

Conclusion: Mortality, injury, and hospitalization rates at both hospitals were consistent with previous reports of open-air mass-casualty terrorist bombings. The TERSH experienced an unprecedented demand for ED surge capacity in an open-air bombing.