US Department of Defense
Advancing Blast Injury Research to Protect and Heal Those Who Serve

The Beirut ammonium nitrate blast: A multicenter study to assess injury characteristics and outcomes

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Treatment data from medical centers in Beiruit after the August 2020 Explosion offer insights for planning in response to similar disasters.

On August 4, 2020, a massive explosion devastated Beirut's city port infrastructure and caused hundreds of casualties. The tragic consequences can offer information to disaster planning processes for other cities, and the difficulties encountered could indicate ways to improve readiness.

Trauma patient data was collected in a two-stage process from patient hospital chart review and follow-up phone calls at five major acute-care hospitals in metropolitan Beirut up to 4 days post blast.

  • A total of 791 patients with a mean age of 42 years were included.
  • The mean distance from the blast was 2.4 km (SD, 1.9 km);
  • 3.1% of victims were in the Beirut Port itself.
  • The predominant mechanism of injury was being struck by an object (falling/projectile) (293 [37.0%]), and the most frequent site of injury was the head/face (209 [26.4%]).
  • Injury severity was low for 548 patients (71.2%), moderate for 62 (8.1%), and severe/critical for 27 (3.5%).
  • Twenty-one deaths (2.7%) were recorded.

Significant serious injury predictors (Injury Severity Score, >15) were extracted from the data. Twenty-five percent were admitted to the hospital, with 4.6% requiring the intensive care unit. At discharge, 25 patients (3.4%) had recorded neurologic disability. This study shows the likely array of injuries from a major blast in a city. Falling objects and projectiles are significant in injury causes, but a small significant number of people sustain serious injuries. The data from this study allows a risk assessment for large-scale explosive events in modern cities, and it can guide the process of preparation for these potential events.

For government installations, such as bases, the data indicates that similar explosive events (such as truck bombs) could generate significant injury from falling objects. Also, a large number of low-severity injuries and a small number of severe injuries could be expected.


Al-Hajj S, Farran SH, Zgheib H, Tfaily MA, Halaoui A, Wehbe S, Karam S, Fadlallah Y, Fahd F, Toufaili L, Arjinian S, Al-Zaghrini E, Al Hariri M, El Hussein M, Souaiby N, Mowafi H, Mufarrij AJ. The Beirut ammonium nitrate blast: A multicenter study to assess injury characteristics and outcomes. J Trauma Acute Care Surg. 2023 Feb 1;94(2):328-335. doi: 10.1097/TA.0000000000003745. Epub 2022 Aug 24. PMID: 35999664.

Last modified: 02-May-2023