Introduction: Despite nearly a decade of conflict, little is known about trauma and injuries resulting from the Syrian war.
Methods: Secondary analysis was conducted of an administrative dataset of patient presentations to a network of 95 war-affected hospitals in Syria from July 2013 - July 2015. Logistic regression was performed to identify factors associated with mortality of neurotrauma patients.
Results: Of 193,618 overall trauma presentations, 41,143 were for neurotrauma (37,410 head trauma, 1,407 spinal trauma and 3,133 peripheral nervous system). There were 31,359 males (76.2%) and 9,784 females (23.8%). Males aged 19-30 years (10,113; 24.6%) were the largest single demographic group. Presumed non-combatants including females, elders and children under 13 years (16,214; 39.4%) were the largest group of patients overall. There were 16,881 (41.0%) presentations with blunt injuries (blunt/crush injuries) and 21,307 (51.8%) patients with penetrating injuries (shrapnel, cut, gunshot). A total of 36,589 patients (89.6%) were treated and discharged from the hospital, 2,100 (5.1%) were transferred to another facility, 2,050 patients (5.0%) died in-hospital, 26 remained in the hospital (0.1%), 108 (0.3%) had unknown disposition. The median length of hospital stay was 1 day. There were 4,034 (9.7%) neurosurgical procedures documented. Patients with combined neurotrauma and general trauma suffered 30 times higher mortality than neurotrauma alone (aOR: 30.4; 95%CI: 20.8-44.2, p<0.0001).
Conclusion: The Syrian War resulted in large volumes of neurotrauma patients. Presumed non-combatants comprised 39.4% of patients who survived to treatment at a facility. Further study is needed on long-term needs of neurotrauma victims of the Syrian war.