Causes of infections in penetrating head wounds in the Iran-Iraq war

ABSTRACT

In a retrospective study, the incidence of central nervous system infectious complications of 913 patients were studied during the eight year Iran-Iraq war. The overall infection rate was 9.9% [91/913]. Infection rate was 4.4 percent in 412 patients who were primarily operated at Nemazee Hospital [Group A]. In 224 patients who were primarily operated in frontline hospitals, the infection rate was 15.6 percent [Group C]. Infection rate was 15.9% in a third group of patients [No. 277] who were secondarily explored in our center [Group B]. The increase in infection rate between Group A and B, and A and C is statistically significant [X[2]=22.6 and 21.3 respectively]. Up to seventy percent of the organisms cultured were gram negative which resulted in a mortality rate of 68%. Mortality was 15 percent in patients having gram positive central nervous system infections. Klebsiella, pneumonia and Staph aureus coag positive were among the most frequent organisms. One hundred twenty-six patients died during the study, of which 38 were due to infection [30%]. The overall mortality from infection was 4% [38/913]. In conclusion, patients may have a better prognosis, in terms of infection rate, if they are sent directly from the front line to a large medical center