Brethauer Stacy A, Chao Alex, Chambers Lowell W, Green Donald J, Brown Carlos, Rhee Peter, Bohman Harold R
Department of Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, M61, Cleveland, OH 44195, USA.
Arch Surg. 2008 Jun;143(6):564-9. doi: 10.1001/archsurg.143.6.564.
The transition from maneuver warfare to insurgency warfare has changed the mechanism and severity of combat wounds treated by US Marine Corps forward surgical units in Iraq.
Case series comparison.
Forward Resuscitative Surgical System units in Iraq.
Three hundred thirty-eight casualties treated during the invasion of Iraq in 2003 (Operation Iraqi Freedom I [OIF I]) and 895 casualties treated between March 2004 and February 2005 (OIF II).
Definitive and damage control procedures for acute combat casualties.
Mechanism of injury, procedures performed, time to presentation, and killed in action (KIA) and died of wounds (DOW) rates.
More major injuries occurred per patient (2.4 vs 1.6) during OIF II. There were more casualties with fragment wounds (61% vs 48%; P = .03) and a trend toward fewer gunshot wounds (33% vs 43%; P = .15) during OIF II. More damage control laparotomies (P = .04) and more soft tissue debridements (P < .001) were performed during OIF II. The median time to presentation for critically injured US casualties during OIF I and OIF II were 30 and 59 minutes, respectively. The KIA rate increased from 13.5% to 20.2% and the DOW rate increased from 0.88% to 5.5% for US personnel in the First Marine Expeditionary Force area of responsibility.
The transition from maneuver to insurgency warfare has changed the type and severity of casualties treated by US Marine Corps forward surgical units in Iraq. Improvised explosive devices, severity and number of injuries per casualty, longer transport times, and higher KIA and DOW rates represent major differences between periods. Further data collection is necessary to determine the association between transport times and mortality rates.
从机动战向游击战的转变改变了美国海军陆战队前沿外科部队在伊拉克治疗的战斗创伤的机制和严重程度。
病例系列比较。
伊拉克的前沿复苏外科系统部队。
2003年伊拉克入侵期间（伊拉克自由行动I [OIF I]）治疗的338名伤员以及2004年3月至2005年2月期间（OIF II）治疗的895名伤员。
对急性战斗伤员的确定性和损伤控制程序。
受伤机制、实施的程序、就诊时间以及阵亡（KIA）和伤死（DOW）率。
在OIF II期间，每名患者发生的重伤更多（2.4比1.6）。在OIF II期间，有更多弹片伤伤员（61%比48%；P = 0.03），枪伤伤员有减少趋势（33%比43%；P = 0.15）。在OIF II期间进行了更多的损伤控制剖腹术（P = 0.04）和更多的软组织清创术（P < 0.001）。在OIF I和OIF II期间，美国重伤员的中位就诊时间分别为30分钟和59分钟。在第一海军陆战队远征军负责区域，美国人员的KIA率从13.5%升至20.2%，DOW率从0.88%升至5.5%。
从机动战向游击战的转变改变了美国海军陆战队前沿外科部队在伊拉克治疗的伤员类型和严重程度。简易爆炸装置、伤员的严重程度和受伤数量、更长的运输时间以及更高的KIA和DOW率是不同时期的主要差异。需要进一步收集数据以确定运输时间与死亡率之间的关联。
