Death on the battlefield (2001-2011): Implications for the Future of Combat Casualty Care

Abstract

Critical evaluation of all aspects of combat casualty care, including mortality, with a special focus on the incidence and causes of potentially preventable deaths among US combat fatalities, is central to identifying gaps in knowledge, training, equipment, and execution of battlefield trauma care. The impetus to produce this analysis was to develop a comprehensive perspective of battlefield death, concentrating on deaths that occurred in the pre-medical treatment facility (pre-MTF) environment. METHODS: The Armed Forces Medical Examiner Service Mortality Surveillance Division was used to identify Operation Iraqi Freedom and Operation Enduring Freedom combat casualties from October 2001 to June 2011 who died from injury in the deployed environment. The autopsy records, perimortem records, photographs on file, and Mortality Trauma Registry of the Armed Forces Medical Examiner Service were used to compile mechanism of injury, cause of injury, medical intervention performed, Abbreviated Injury Scale (AIS) score, and Injury Severity Score (ISS) on all lethal injuries. All data were used by the expert panel for the conduct of the potential for injury survivability assessment of this study. RESULTS: For the study interval between October 2001 and June 2011, 4,596 battlefield fatalities were reviewed and analyzed. The stratification of mortality demonstrated that 87.3% of all injury mortality occurred in the pre-MTF environment. Of the pre-MTF deaths, 75.7% (n = 3,040) were classified as nonsurvivable, and 24.3% (n = 976) were deemed potentially survivable (PS). The injury/physiologic focus of PS acute mortality was largely associated with hemorrhage (90.9%). The site of lethal hemorrhage was truncal (67.3%), followed by junctional (19.2%) and peripheral-extremity (13.5%) hemorrhage.

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Document Details

Document Type
Technical Report
Publication Date
Dec 01, 2012
Accession Number
ADA609264

Entities

People

  • Brian J. Eastridge
  • Joyce Cantrell
  • Lynne Oetjen-gerdes
  • Olga Mallett
  • Paul Uribe
  • Peter Seguin
  • Robert L. Mabry
  • Tamara Zubko
  • Terrill Tops
  • Todd E Rasmussen

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Brain Injuries
  • Casualties
  • Combat Casualty Care
  • Combat Injuries
  • Health Services
  • Injury Prevention
  • Medical Personnel
  • Military Medicine
  • Physicians
  • Therapy
  • Warfare

Fields of Study

  • Medicine

Readers

  • Systems Analysis and Design
  • Trauma or Military Medicine