Injury Severity and Causes of Death From Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006

## Joseph F. Kelly, MD, Amber E. Ritenour, MD, Daniel F. McLaughlin, MD, Karen A. Bagg, MS, Amy N. Apodaca, MS, Craig T. Mallak, MD, Lisa Pearse, MD, Mary M. Lawnick, RN, BSN, Howard R. Champion, MD, Charles E. Wade, PhD, and COL John B. Holcomb, MC

The Journal of TRAUMA, Injury, Infection, and Critical Care

J Trauma. 2008;64:S21?S27.

#### Description with Key Points:

The opinion that injuries sustained in Iraq and Afghanistan have increased in severity is widely held by clinicians who have deployed multiple times. To continuously improve combat casualty care, the Department of Defense has enacted numerous evidence-based policies and clinical practice guidelines. Overall causes of death were examined, looking for opportunities of improvement for research and training.

In the time periods of the war studied, deaths per month has doubled, with increases in both injury severity and number of wounds per casualty. Truncal hemorrhage is the leading cause of potentially survivable deaths. Arguably, the success of the medical improvements during this war has served to maintain the lowest case fatality rate on record.

Key Chart:
Injury Severity and Causes of Death From OIF and OEF: 2003-2004 Versus 2006
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# Take Home Message:

More recent data from Iraq and Afghanistan show hemorrhage is still the major cause of potentially preventable deaths. We are doing better than ever in regards to managing preventable deaths on the battlefield, but studies show we still have room for improvement.