UTSA study quantifies injuries and combat casualty care trends during War on Terror

March 27, 2019

Thousands of military service members lost their lives or were severely injured while serving our country during America's longest war, known as the Global War on Terrorism. A researcher at The University of Texas at San Antonio (UTSA) is now documenting the war's casualty statistics, mortality trends and treatment advances.

UTSA researcher, Jeffrey Howard, published an article today in JAMA Surgery that takes a closer look at the casualties of war and the trauma care they received during the military conflicts in Afghanistan and Iraq that began after September 11, 2001.

Howard, the paper's lead author and an assistant professor in the Department of Kinesiology, Health and Nutrition in the UTSA College of Education and Human Development (COEHD), and his collaborators analyzed data compiled from Department of Defense (DoD) databases about the 56,763 injuries recorded in Afghanistan and Iraq from October 1, 2001 through December 31, 2017.

The researchers assessed casualty status (alive, killed in action (KIA) or died of wounds (DOW), the case-fatality rate (CFR) and the contribution of different interventions (use of tourniquets, blood transfusions, and transport to surgical facility within 60 minutes) to changes in the CFR.

"The Afghanistan and Iraq conflicts have the lowest case-fatality rates in U.S. history, but the purpose of this study was to provide the most comprehensive assessment of the trauma system by compiling the most complete data on the conflicts and analyzing multiple interventions and policy changes simultaneously," explained Howard. "We used novel analytical methods to simulate what mortality would have been without key interventions."

Key findings suggest that injury patterns and the severity of sustained injuries increased during the war. For example: Three key interventions (increased use of tourniquets, increased use of blood transfusion, and more rapid hospital transport times, especially in Afghanistan) were responsible for about a 44 percent of the reduction in mortality. The researchers estimate that 1,622 lives were saved from these interventions.

They also found that without these changes in intervention and policy, an estimated 3,600 additional deaths would have occurred between 2001 and 2017.

Howard says the paper is an extension of his previous work as a DoD epidemiologist and researcher evaluating trauma care practices, like the use of blood transfusions and the transport of casualties to medical treatment facilities.

"My prior work involved evaluating the DoD policy changes mandated by former Secretary of Defense Robert Gates regarding the reduction of transportation times and other trauma care guidelines," said Howard. "In the past, we had to assess these questions with less complete data than what was compiled for this current study."

The UTSA researcher noted that more critically injured military service members reached surgical care, with increased survival rates, which suggests that there were improvements in hospital care as well.

Howard said one of the main goals of this current work is to ensure that the lessons of war are not lost.

"Many of the lessons from the current war had actually been learned before in prior wars," he said. "My colleagues and I are trying to propagate these lessons throughout the scientific and medical literature to inform military trauma care policies for the future."
-end-


University of Texas at San Antonio

Related Mortality Articles from Brightsurf:

Being in treatment with statins reduces COVID-19 mortality by 22% to 25%
A research by the Universitat Rovira i Virgili (URV) and Pere Virgili Institut (IISPV) led by LluĂ­s Masana has found that people who are being treated with statins have a 22% to 25% lower risk of dying from COVID-19.

Mortality rate higher for US rural residents
A recent study by Syracuse University sociology professor Shannon Monnat shows that mortality rates are higher for U.S. working-age residents who live in rural areas instead of metro areas, and the gap is getting wider.

COVID-19, excess all-cause mortality in US, 18 comparison countries
COVID-19 deaths and excess all-cause mortality in the U.S. are compared with 18 countries with diverse COVID-19 responses in this study.

New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin
A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality.

Hydroxychloroquine reduces in-hospital COVID-19 mortality
An Italian observational study contributes to the ongoing debate regarding the use of hydroxychloroquine in the current pandemic.

What's the best way to estimate and track COVID-19 mortality?
When used correctly, the symptomatic case fatality ratio (sCFR) and the infection fatality ratio (IFR) are better measures by which to monitor COVID-19 epidemics than the commonly reported case fatality ratio (CFR), according to a new study published this week in PLOS Medicine by Anthony Hauser of the University of Bern, Switzerland, and colleagues.

COVID-19: Bacteriophage could decrease mortality
Bacteriophage can reduce bacterial growth in the lungs, limiting fluid build-up.

COPD and smoking associated with higher COVID-19 mortality
Current smokers and people with chronic obstructive pulmonary disease (COPD) have an increased risk of severe complications and higher mortality with COVID-19 infection, according to a new study published May 11, 2020 in the open-access journal PLOS ONE by Jaber Alqahtani of University College London, UK, and colleagues.

Highest mortality risks for poor and unemployed
Large dataset shows that income, work status and education have a clear influence on mortality in Germany.

Addressing causes of mortality in Zambia
Despite the fact that people in sub-Saharan Africa are now living longer than they did two decades ago, their average life expectancy remains below that of the rest of the world population.

Read More: Mortality News and Mortality Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.