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Epidemiology of traumatically injured Yemeni civilians treated at the Omani National Trauma Centre over a 2-year period: a retrospective cohort study
  1. Prashanth Ramaraj1,
  2. T Al-Buluchi2,
  3. S Al-Shaqsi2,
  4. A Al-Kashmiri2,
  5. Z B Perkins1 and
  6. H D De'Ath1
  1. 1Centre for Trauma Sciences, Queen Mary University of London, London, UK
  2. 2Department of Plastic Surgery, Khoula Hospital, Mina Al Fahal, Oman
  1. Correspondence to Mr Prashanth Ramaraj, Centre for Trauma Sciences, Queen Mary University of London, London E1 2AT, UK; pr1113{at}


Introduction Armed conflict is a growing global cause of death, posing a significant threat to the resilience of global health systems. However, the burden of disease resulting from the Yemeni Civil War remains poorly understood. Approximately half of healthcare facilities in Yemen are non-operational, and around 15% of the population has been displaced. Consequently, neighbouring countries’ trauma systems have been providing care to the injured. The objective of this study was to investigate the epidemiology and management of Yemeni civilian victims injured during the war who were subsequently extracted and treated at the study centre in Oman.

Methods We conducted a retrospective cohort study, including all Yemeni civilians treated for traumatic injuries at the study centre from January 2015 to June 2017. We extracted data on age, sex, date of attendance, mechanism of injury, injuries sustained and treatment.

Results A total of 254 injured patients were identified. Their median age was 25 (range 3–65) years and 244 (96.1%) were male. Explosions (160 patients, 63.0%) were the most common mechanism of injury, and fractures (n=232 fractures, 42.3% of all injuries; in 149 patients, 58.7% of all patients) the most common injury. Eighty-four of the 150 patients (56%) who received operative management at the study centre were receiving a second procedure after an index procedure outside of Oman.

One hundred and twenty-eight (50.4%) patients experienced permanent loss of function in at least one body part and/or limb loss.

Conclusions This study demonstrates the downstream needs of Yemeni civilians who were evacuated to the study centre, revealing a considerable burden of morbidity associated with this population. The findings emphasise key areas that receiving hospitals should prioritise in resource allocation when managing conflict-wounded evacuees. Additionally, the study underscores the need for holistic rehabilitation for civilian casualties displaced by conflict.


Data availability statement

Data are available upon reasonable request. The authors will support data sharing on request by emailing the corresponding author, PR.

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Data availability statement

Data are available upon reasonable request. The authors will support data sharing on request by emailing the corresponding author, PR.

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  • Contributors PR was involved in conception of idea, study design, data gathering and analysis, and writing. TB, SS and AK were involved in clinical care of patients, data gathering and review. HDD and ZBP were involved in internal review and writing. Author PR is the article's guarantor and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.