Death on the battlefield (2001–2011): Implications for the future of combat casualty care

  title={Death on the battlefield (2001–2011): Implications for the future of combat casualty care},
  author={Brian J. Eastridge and Robert L. Mabry and Peter G Seguin and Joyce Cantrell and Terrill L. Tops and Paul Uribe and Olga Mallett and Tamara Zubko and Lynne Oetjen-Gerdes and Todd E. Rasmussen and Frank K. Butler and Russell S. Kotwal and John B. Holcomb and Charles E. Wade and Howard R. Champion and Mimi Lawnick and Leon E. Moores and Lorne H. Blackbourne},
  journal={Journal of Trauma and Acute Care Surgery},
BACKGROUND 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. [] Key Method 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…

Mortality review of US Special Operations Command battle-injured fatalities

Comprehensive mortality reviews of battlefield fatalities can identify OFI in combat casualty care and prevention and standardized lexicon is essential for translation to civilian trauma systems.

Re-examination of a Battlefield Trauma Golden Hour Policy.

Reduction in KIA mortality is associated with early treatment capabilities, blunt mechanism, select body locations of injury, and rapid transport.

Died of wounds: a mortality review

Severe head injury was the most common cause of death of casualties deemed to have died from their injuries after arriving at a medical treatment facility during the recent conflicts in Iraq and Afghanistan, and none of this group had salvageable injuries.

Ahead of the curve: Sustained innovation for future combat casualty care.

Results from this analysis show that, as a percentage of all combat-related deaths during the course of the wars, 76% were in the prehospital setting, and that the work is not done to improve prehospital care and alleviate the burden of survivorship, resulting from effective lifesaving efforts.

Challenges to improving combat casualty survival on the battlefield.

Improving pre - hospital combat casualty care may be significantly more challenging than improving hospital-based casualty care because of significant structural challenges facing the military medical establishment.

Changing patterns of in-hospital deaths following implementation of damage control resuscitation practices in US forward military treatment facilities.

There has been a significant shift in resuscitation practices in forward combat hospitals indicating widespread military adoption of DCR, and patients who died in a hospital during the DCR period were more likely to be severely injured and have a severe brain injury, consistent with a decrease in deaths among potentially salvageable patients.

United States Special Operations Command Fatality Study of Subcommands, Units, and Trends.

Organizational differences in mortality characteristics and trends were identified from which commanders can refine efforts to prevent and treat injury and improve survival and advance casualty prevention and response efforts.

The effect of prehospital transport time, injury severity, and blood transfusion on survival of US military casualties in Iraq

Although data were limited, early blood transfusion was associated with battlefield survival in Iraq as it was in Afghanistan, and critical casualties had lower mortality when blood was received than other casualties.

Preventable death and interpersonal violence in the United States: who can be saved?

It is hypothesized that many homicide deaths are due to non-survivable injuries, and that an effective strategy to reduce mortality must focus on both primary prevention as well as improvement in trauma pre-hospital care.



Died of wounds on the battlefield: causation and implications for improving combat casualty care.

Hemorrhage is a major mechanism of death in PS combat injuries, underscoring the necessity for initiatives to mitigate bleeding, particularly in the prehospital environment.

Causes of Death in U.S. Special Operations Forces in the Global War on Terrorism: 2001–2004

The majority of deaths on the modern battlefield are nonsurvivable, and improved methods of intravenous or intracavitary, noncompressible hemostasis combined with rapid evacuation to surgery may increase survival.

Eliminating preventable death on the battlefield.

A command-directed casualty response system that trains all personnel in Tactical Combat Casualty Care and receives continuous feedback from prehospital trauma registry data facilitated performance improvements that resulted in unprecedented reduction of killed-in-action deaths, casualties who died of wounds, and preventable combat death.

Decreasing killed in action and died of wounds rates in combat wounded.

Because of the potential for prolonged evacuation time during combat operations and the relatively limited options available for treatment of truncal penetrating injury before admission to a surgical facility, the prehospital phase of evacuation offers the greatest opportunity to mitigate the hemorrhagic sequels of battlefield injury.

Fatal Airway Injuries during Operation Enduring Freedom and Operation Iraqi Freedom

This was a subgroup analysis of cases previously examined by Kelly and colleagues, who reviewed autopsies of military personnel who died in combat in Iraq and Afghanistan between 2003 and 2006, finding that airway compromise from battlefield trauma results in a small number of PS fatalities.

A profile of combat injury.

Recognition of differences in combat trauma can help bring focus to resuscitation research for combat settings and can serve to foster greater civilian-military collaboration in both basic and transitional research.

Epidemiology of trauma: military experience.

Tactical combat casualty care in the Canadian Forces: lessons learned from the Afghan war.

The principles of TCCC are reviewed and some of the lessons learned about battlefield trauma care during this conflict are reviewed.

United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield.

The incidence of fatal head wounds was similar to that in Vietnam in spite of modern Kevlar helmets, and body armor reduced the number of fatal penetrating chest injuries.