P3D325: Pediatric Inpatient Admissions Following Evacuation from Afghanistan: A Single Center, Descriptive Study

Background: In August 2021, large-scale evacuations from Afghanistan occurred following the collapse of the Afghan government and the withdrawal of U.S. troops. In the complex humanitarian crisis that followed, over 10,000 individuals were evacuated from Kabul, Afghanistan, to the region served by the U.S. military treatment facility Landstuhl Regional Medical Center (LRMC). This study provides a detailed characterization of the illness and injury patterns among pediatric patients who received inpatient care at LRMC following the evacuation.

Methods: A retrospective chart review was performed. Inclusion criteria were those who were less than 18 years of age, had evacuated from Afghanistan, and who were admitted to LRMC during the timeframe when evacuees received lodging at surrounding U.S. military bases. Diagnosis codes, procedures, pertinent lab results, lengths of stay, and dispositions were extracted and analyzed.

Results: 55 pediatric patients were identified, in addition to newborns born to mothers who had been evacuated. Analysis of non-newborn patients demonstrated three broad categories of patients: polytrauma that resulted from the bombing at the Kabul airport, chronic medical conditions that required ongoing care, and infection-related illnesses. Trauma victims suffered a high rate of penetrating injuries, were more likely to require mechanical ventilation and intensive care unit support, and had longer lengths of stays. Trauma victims and those with chronic medical conditions were more likely to require transfer to another military treatment facility. The most common infection-related admissions were measles and gastroenteritis.

Conclusion: Analysis of pediatric admissions is important to understand the profound impact these events had on children. Among those admitted to LRMC, trauma victims were the most complex and had the highest resource utilization per patient. Chronic underlying medical diagnoses also required substantial multispecialty care and inpatient support. Defining these illness patterns can help inform pediatric care during future humanitarian crises.

Disclaimer: The authors report they have no conflicts of interest. The opinions and assertions contained herein are those of the authors and do not reflect those of the Uniformed Services University, Landstuhl Regional Medical Center, the US Army, or the Department of Defense.