Ten Years of Military Pediatric Care in Afghanistan and Iraq

Abstract

Background: Besides care for injured US military personnel, doctrine also requires life-, limb-, and eyesight-saving care to all injured casualties, including children. This study s objective was to evaluate the burden and epidemiology of pediatric medical care during the past decade of military operations in Iraq and Afghanistan. METHODS: Retrospective review of two military registries of all patients admitted to combat support hospitals and forward surgical teams from 2001 through 2011 was conducted. Pediatric (PED) patients were defined as younger than 18 years. Adult patients were divided into local civilian/noncoalition military (LOCAL) and coalition (COALITION) soldiers. RESULTS: A total of 7,505 PED patients, 25,459 LOCAL adults, and 95,618 COALITION soldiers were analyzed in the primary registry. Children represented 5.8% of all admissions (11% bed days), LOCAL adults represented 20% (36% bed days), and COALITION soldiers represented 74% (53% bed days). PED median (interquartile range) length of stay was 3 days (1 7 days), longer than LOCAL with 2 days (1 6 days), and COALITION with 1 day (1 2 days) ( p G 0.001). PED Injury Severity Score (ISS) was 9 (4 16), similar to LOCAL with 9 (4 16) but higher than COALITION with 5 (2 10) ( p G 0.001). Mortality in trauma patients was highest in PED (8.5%) compared with LOCAL (7.1%) and COALITION (3%) ( p G 0.01). Mechanisms of injury for PED trauma were blast (37%), penetrating (27%), blunt (23%), and burn (13%). Factors independently associated with PED mortality included ISS (odds ratio, 95% confidence interval) (1.08, 1.06 1.09), Glasgow Coma Scale (GCS) score (0.85, 0.82 0.88), base excess (0.87, 0.85 0.90), female sex (1.73, 1.18 2.52), age less than 8 years (1.43, 1.00 2.04), and burns (3.17, 1.89 5.32).

Open PDF

Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2012
Accession Number
ADA619888

Entities

People

  • Lorne H Blackbourne
  • Matthew Borgman
  • Philip C Spinella
  • Renee I. Matos

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Afghanistan
  • Afghanistan Conflict
  • Age Groups
  • Burns
  • Combat Injuries
  • Combat Support
  • Combat Support Hospitals
  • Databases
  • Debridement
  • Health Services
  • Iraqi-War
  • Medical Personnel
  • Military Medicine
  • Military Personnel
  • Physicians
  • Warfare
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

  • Trauma or Military Medicine