Capsule Summary
What is already known on this topic
Very little has been reported about the epidemiology and outcomes of mass casualty terrorist bombing attacks in the civilian setting.
What question this study addressed
Thirty-five published reports of terrorist bombings producing 30 or more casualties and with sufficient data on outcomes were reviewed and summarized.
What this study adds to our knowledge
Among the 8,634 casualties, most deaths were immediate (and untreatable). Both early (emergency department [ED]) and late (inhospital) mortality rates were 1% or less, ED utilization by victims ranged from 48% to 94%, and hospitalization rates ranged from 15% to 36%.
How this might change clinical practice
EDs will rarely be presented with a large influx of critical patients. Rates of ED utilization vary with the structural environment of the bombing site, allowing some prediction of ED and hospital bed capacity needs. Enhancing field care and rescue, especially for victims of structural collapse, may be important.