Schauer Steven G, April Michael D, Naylor Jason F, Maddry Joseph K, Keen Donald E, Cunningham Cord W, Becker Tyson E, Walters Thomas, Keenan Sean
US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, United States.
59th Medical Wing, JBSA Lackland, Texas, United States.
Afr J Emerg Med. 2019;9(Suppl):S43-S46. doi: 10.1016/j.afjem.2018.09.004. Epub 2018 Oct 12.
The United States (US) military has expanded its area of operations into Africa. This medically immature theater is spread across a large region where prolonged field care (PFC) events are likely to occur. We describe trauma cases reported in the Africa Command (AFRICOM) area of operations to date within the Department of Defense Trauma Registry (DODTR).
We queried the DODTR for all subjects evacuated from the AFRICOM area of operations from January 2002 to June 2017.
There were 49 subjects in the registry during our time frame from AFRICOM. Most of the evacuations came from Djibouti (53%). The median age was 29 years, most evacuees being male (92%). Non-battle injuries accounted for most of the injuries (82%), and most were US military (90%). All battle injuries were gunshot wounds (GSW). Composite injury scores were low (median 4, IQR 4-9.5). All subjects survived to hospital discharge. GSWs (22%) and sports injuries (24%) accounted for most evacuations. Serious injuries most frequently involved the extremities (18%) and the thorax (12%). The most frequent major injuries were open fractures (22%) and abdominal injuries (10%). The most frequent facility-based interventions performed were wound debridement (29%) and fracture/joint dislocation reduction (22%).
Based on this dataset, most of the injuries from AFRICOM were non-battle injuries. All battle injuries were GSWs. Our study highlights the differences in casualty care needs in this region which contrast the primary explosive-based injuries seen within United States Central Command (CENTCOM) operations. The limitations of this dataset highlight the potential value of a Joint Trauma Service (JTS) data collection mandate and resource support for units within this region to facilitate targeted improvements in medical care.
美国军队已将其行动区域扩展至非洲。这个医疗条件尚不完善的战区分布在一个广大区域，长时间战地护理（PFC）事件很可能在此发生。我们描述了美国国防部创伤登记处（DODTR）截至目前在非洲司令部（AFRICOM）行动区域报告的创伤病例。
我们查询了DODTR中2002年1月至2017年6月从AFRICOM行动区域后送的所有对象。
在我们所研究的时间段内，AFRICOM有49名对象被登记在册。大多数后送人员来自吉布提（53%）。年龄中位数为29岁，大多数后送人员为男性（92%）。非战斗伤占大多数（82%），且大多数是美军人员（90%）。所有战斗伤均为枪伤（GSW）。综合损伤评分较低（中位数4，四分位间距4 - 9.5）。所有对象均存活至出院。枪伤（22%）和运动损伤（24%）占后送原因的大多数。重伤最常累及四肢（18%）和胸部（12%）。最常见的重伤为开放性骨折（22%）和腹部损伤（10%）。最常进行的基于医疗机构的干预措施是伤口清创（29%）和骨折/关节脱位复位（22%）。
基于该数据集，AFRICOM的大多数损伤为非战斗伤。所有战斗伤均为枪伤。我们的研究突出了该地区伤亡护理需求的差异，这与美国中央司令部（CENTCOM）行动中主要基于爆炸物的损伤形成对比。该数据集的局限性凸显了联合创伤服务（JTS）数据收集指令以及为该地区各部队提供资源支持的潜在价值，以促进医疗护理的针对性改进。
