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Cohort studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026

High-velocity gunshot chest trauma: tailoring patient care through insights from a mass casualty experience.

Aviel Avraham Azulay, Michael Stein, Limor Yamit Tabo … Yael Refaely

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Internal MedicineCohort study

Venous thromboembolism occurred in nearly half of high-velocity gunshot chest wound patients.

High-velocity gunshot chest trauma: tailoring patient care through insights from a mass casualty experience.

Aviel Avraham Azulay … Yael Refaely

European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026

Background

The analysis focuses on damage control surgical techniques, the incidence and timeline of venous thromboembolism (venous thromboembolism), regional pain management, and early psychiatric protocols.

Purpose

This study describes the management strategies and clinical outcomes of a cohort of patients sustaining high-velocity military rifle gunshot wounds to the thorax during a mass casualty incident (mass casualty incident).

Methods

Presenting with multi-system trauma involving entirely separate, distant anatomical regions were excluded.

n = 4 patients

Results

45.5%

nearly half developed a blood clot after their injury

n = 4 patients

More results

The cohort comprised 11 male patients (age range: 19-49 years; 9 soldiers, 2 civilians) injured by 7.62 mm assault rifle rounds.

Four patients (36.4%) underwent delayed, elective surgical stabilization of rib fractures.

More results

Ipsilateral brachial plexus injury was present in 63.6% (n = 7), occurring exclusively in patients wearing ballistic protective vests.

Mean hospital length of stay was 15.27 days (range: 2-41).

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Conclusion · 1 of 2

Lung-preserving, suture-based damage control strategies were effective for hemorrhage control during this mass casualty surge and supported rapid operative management in a resource-constrained setting.

Conclusion · 2 of 2

A high incidence of venous thromboembolism (45.5%) was observed, including pulmonary embolism without documented lower-extremity deep vein thrombosis, supporting the need for early post-stabilization diagnostic surveillance.

Post

High-velocity gunshot chest trauma: tailoring patient care through insights from a mass casualty experience.

Venous thromboembolism occurred in nearly half of high-velocity gunshot chest wound patients.

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