Blast injuries in Sweden
Felix Djärf, Tomas Vedin, Mikael EkelundAbstract
Introduction
Blast injuries result from exposure to explosions and vary in mechanism and severity. A recent increase in illegal explosions in Sweden highlights the need for improved understanding of related injuries. This study aimed to describe the epidemiology, injury patterns, and outcomes of hospital-treated blast victims in Sweden using a nationwide retrospective design.
Methods
This retrospective study included all patients registered in the Swedish Trauma Registry (SweTrau) between 2014 and 2023 with blast injury as the primary trauma mechanism. Demographic, clinical, and injury characteristics were analysed descriptively. Predictors of 30-day mortality were assessed using logistic regression.
Results
A total of 272 patients were identified (86.8% male; median age 39.5 years). Most injuries were accidental (90.4%), with an annual incidence of 0.26 per 100 000 and no clear temporal trend. Blunt trauma predominated (79.3%), and the median New Injury Severity Score (NISS) was 4. Nearly half of injuries were categorized as ‘other’, including systemic effects such as thermal and inhalation injuries. Wound revision was the most common initial surgical procedure (15.1%), and 20.6% required intubation. The 30-day mortality rate was 5.9%. Female sex, severe thoracic injury, and severe ‘other’ (thermal) injury were independently associated with mortality.
Discussion
This nationwide study provides foundational epidemiological data on blast injuries in Sweden. Although the incidence was low and stable, these injuries were associated with substantial clinical burden. Severe thoracic and thermal-related injuries were independently associated with mortality, underscoring the importance of early recognition and management of thoracic, burn, and inhalation injuries.