PREDICTION AND PREVENTION OF COMPLICATIONS IN CIVILIANS WITH COMBAT SURGICAL TRAUMA: CURRENT STATE OF THE PROBLEM
DOI:
https://doi.org/10.32782/2411-9164.23.2-7Keywords:
combat trauma, FAST, Damage Control Surgery, mortality, ROC analysis, prognosis, evacuationAbstract
Introduction. Modern hostilities in Ukraine are characterized by high-intensity fire impact and extensive use of explosive and precision weapons, resulting in a significant number of severe combat-related injuries among the civilian population. Under these conditions, early diagnostics, timely surgical decision-making, and appropriate evacuation strategies are critical for reducing mortality. Aim. To analyze the frequency and conditions of applying FAST ultrasonographic screening and Damage Control Surgery (DCS) in civilian casualties with combat trauma and to assess their influence on treatment outcomes. Materials and Methods. The study cohort included 400 civilian patients aged 18–70 years who sustained combat injuries. FAST was performed in 74% of cases, while DCS was applied in 28%. Results. Performing FAST was associated with reduced hospitalization duration and shorter time to surgery (r = –0.68). DCS was associated with lower mortality and decreased need for repeated interventions (r = –0.62). ROC analysis showed that FAST and DCS are not independent predictors of mortality (AUC < 0.5), though their timely application significantly improves clinical outcomes. Conclusions. Systematic implementation of training programs, simulation courses, and competency-building modules for physicians of different specialties is essential to improve the effectiveness of care provided to civilian patients with combat injuries.
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