The impact of body armour on thoracic injury incidences and mortality rates in civilian or military armed conflicts: a systematic review and meta-analysis

Abstract

Background This systematic review and meta-analysis aimed to identify the incidence of chest injuries with and without body armour to understand its effectiveness in reducing or even preventing injury and mortality resulting from armed conflicts in civilian or military settings.

Methods A systematic search was conducted in PubMed, Scopus, Web of Science, and ScienceDirect on June 30, 2023. The Newcastle-Ottawa scale (NOS) was applied to assess the risk of bias in the included studies. A descriptive synthesis approach and meta-analysis (reporting odds ratio [OR]) were used to summarise the findings of chest injuries and mortality rates between protected groups (body armour) versus unprotected groups (no body armour).

Results Six out of the 501 retrieved studies were included. We found a 64% lower injury rate in the protected group compared to the unprotected (OR; 0.36 95% CI [0.19, 0.68], p = 0.002). Furthermore, there was a 55% lower chest injury-related mortality rate for the protected group compared to the unprotected (OR; 0.45 95% CI [0.22, 0.89], p = 0.02). The included studies' NOS mean score was 4.83. We found a strong level of evidence (GRADE approach score = 4).

Discussion Our findings indicate wearing body armour reduces the risk of chest injury and mortality. However, studies were few and the risk of bias was high; hence, further high-quality studies are required to assess the impact of body armour on chest injuries and overall mortality.

Other There is no funding source. The review was registered in PROSPERO with the number [CRD42023442789].