近期冲突中美以两国军队的损伤模式和医护作用分析：两个总比一个好。
Analysis of injury patterns and roles of care in US and Israel militaries during recent conflicts: Two are better than one.
机构信息
From the US Army Institute of Surgical Research, JBSA, Fort Sam Houston, Texas (B.A., E.A.M.-S., T.D.L., L.C.C., J.C.W., K.R.G.); Department of Surgery "A," Meir Medical Center, Kfar Saba and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (A.B., H.P.); Israel Defense Forces Medical Corps (IDF-MC), Ramat Gan, Israel (A.B., A.Y., B.T., D.D., E.G.); Department of Military Medicine, Hebrew University, Jerusalem, Israel (B.T.); The Geneva Foundation, Tacoma, Washington (B.A.).
出版信息
J Trauma Acute Care Surg. 2016 Nov;81(5 Suppl 2 Proceedings of the 2015 Military Health System Research Symposium):S87-S94. doi: 10.1097/TA.0000000000001252.
BACKGROUND
As new conflicts emerge and enemies evolve, military medical organizations worldwide must adopt the "lessons learned." In this study, we describe roles of care (ROCs) deployed and injuries sustained by both US and Israeli militaries during recent conflicts. The purpose of this collaborative work is facilitate exchange of medical data among allied forces in order to advance military medicine and facilitate strategic readiness for future military engagements that may involve less predictable situations of evacuation and care, such as prolonged field care.
METHODS
This retrospective study was conducted for the periods of 2003 to 2014 from data retrieved from the Department of Defense Trauma Registry and the Israel Defense Force (IDF) Trauma Registry. Comparative analyses included ROC capabilities, casualties who died of wounds, as well as mechanism of injury, anatomical wound distribution, and Injury Severity Score of US and IDF casualties during recent conflicts.
RESULTS
Although concept of ROCs was similar among militaries, the IDF supports increased capabilities at point of injury and Role 1 including the presence of physicians, but with limited deployment of other ROCs; conversely, the US maintains fewer capabilities at Role 1 but utilized the entire spectrum of care, including extensive deployment of Roles 2/2+, during recent conflicts. Casualties from US forces (n = 19,005) and IDF (n = 2,637) exhibited significant differences in patterns of injury with higher proportions of casualties who died of wounds in the US forces (4%) compared with the IDF (0.6%).
CONCLUSIONS
As these data suggest deployed ROCs and injury patterns of US and Israeli militaries were both conflict and system specific. We envision that identification of discordant factors and common medical strategies of the two militaries will enable strategic readiness for future conflicts as well as foster further collaboration among allied forces with the overarching universal goal of eliminating preventable death on the battlefield.
背景
随着新冲突的出现和敌人的演变，世界各国的军事医疗组织必须吸取“经验教训”。在这项研究中，我们描述了美国和以色列军队在最近的冲突中部署的护理角色（ROCs）和受伤情况。这项合作研究的目的是促进盟军之间的医疗数据交流，以推进军事医学的发展，并为未来可能涉及到更不可预测的撤离和护理情况的军事行动做好战略准备，例如延长现场护理。
方法
这项回顾性研究是在 2003 年至 2014 年期间，从国防部创伤登记处和以色列国防军（IDF）创伤登记处检索的数据中进行的。比较分析包括 ROC 能力、因伤死亡的伤员，以及美军和以军伤员在最近冲突中的受伤机制、解剖伤口分布和损伤严重程度评分。
结果
尽管各国军队的 ROC 概念相似，但 IDF 支持在受伤点增加能力和一级角色，包括医生的存在，但二级/二级+以上角色的部署有限；相反，美军在一级角色上保持较少的能力，但在最近的冲突中利用了整个护理范围，包括广泛部署二级/二级+以上角色。来自美军（n=19005）和 IDF（n=2637）的伤员在受伤模式上存在显著差异，美军因伤死亡的伤员比例（4%）明显高于 IDF（0.6%）。
结论
正如这些数据所表明的，美国和以色列军队部署的 ROCs 和受伤模式都是特定于冲突和系统的。我们设想，确定这两个军队之间不一致的因素和共同的医疗策略将使他们为未来的冲突做好战略准备，并促进盟军之间的进一步合作，最终目标是消除战场上的可预防死亡。
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