From the Defense Health Agency, Combat Support-Joint Trauma System (R.S.K., E.L.M., C.A.S., H.R.M., J.C.J., J.T.H., F.K.B., J.M.G., S.A.S.), Joint Base San Antonio-Fort Sam Houston, Texas; Uniformed Services University (R.S.K., E.L.M., J.M.G., S.A.S.), Bethesda, Maryland; College of Medicine, Texas A&M University (R.S.K.), College Station, Texas; Armed Forces Medical Examiner System, Defense Health Agency (E.L.M.), Dover Air Force Base, Dover, Delaware; United States Army Institute of Surgical Research (J.M.G.), Joint Base San Antonio-Fort Sam Houston; Center for Translational Injury Research, The University of Texas Health Science Center (J.B.H.), Houston, Texas; Department of Surgery, The University of Texas Health Science Center, University of Texas (J.T.H., B.J.E.), San Antonio, Texas.
J Trauma Acute Care Surg. 2019 Sep;87(3):645-657. doi: 10.1097/TA.0000000000002354.
Studies of fatalities from injury and disease guide prevention and treatment efforts for populations at risk. Findings can inform leadership and direct clinical practice guidelines, research, and personnel, training, and equipment requirements.
A retrospective review and descriptive analysis was conducted of United States Special Operations Command (USSOCOM) fatalities who died while performing duties from September 11, 2001, to September 10, 2018. Characteristics analyzed included subcommand, military activity, operational posture, and manner of death.
Of 614 USSOCOM fatalities (median age, 30 years; male, 98.5%) the leading cause of death was injury (97.7%); specifically, multiple/blunt force injury (34.5%), blast injury (30.7%), gunshot wound (GSW; 30.3%), and other (4.5%). Most died outside the United States (87.1%), during combat operations (85.3%), in the prehospital environment (91.5%), and the same day of insult (90.4%). Most fatalities were with the US Army Special Operations Command (67.6%), followed by the Naval Special Warfare Command (16.0%), Air Force Special Operations Command (9.3%), and Marine Corps Forces Special Operations Command (7.2%). Of 54.6% who died of injuries incurred during mounted operations, most were on ground vehicles (53.7%), followed by rotary-wing (37.3%) and fixed-wing (9.0%) aircrafts. The manner of death was primarily homicide (66.0%) and accident (30.5%), followed by natural (2.1%), suicide (0.8%), and undetermined (0.7%). Specific homicide causes of death were GSW (43.7%), blast injury (42.2%), multiple/blunt force injury (13.8%), and other (0.2%). Specific accident causes of death were multiple/blunt force injury (80.7%), blast injury (6.4%), GSW (0.5%), and other (12.3%). Of accident fatalities with multiple/blunt force injury, the mechanism was mostly aircraft mishaps (62.9%), particularly rotary wing (68.4%).
Most USSOCOM fatalities died abroad from injury in the prehospital setting. To improve survival from military activities worldwide, leaders must continue to optimize prehospital capability and develop strategies that rapidly connect patients to advanced resuscitative and surgical care.
Epidemiological, level IV; Therapeutic level IV.
对伤害和疾病导致的死亡进行研究有助于指导高危人群的预防和治疗工作。研究结果可以为领导层提供信息，并直接指导临床实践指南、研究以及人员、培训和设备需求。
对 2001 年 9 月 11 日至 2018 年 9 月 10 日期间，在美国特种作战司令部（USSOCOM）执行任务时死亡的人员进行了回顾性审查和描述性分析。分析的特征包括下属司令部、军事活动、作战态势和死亡方式。
在 614 名 USSOCOM 死亡人员中（中位数年龄为 30 岁；男性占 98.5%），导致死亡的主要原因是伤害（97.7%）；具体来说，多发/钝器伤（34.5%）、爆炸伤（30.7%）、枪伤（30.3%）和其他（4.5%）。大多数死亡发生在美国境外（87.1%）、战斗行动中（85.3%）、院外环境中（91.5%）和受伤当天（90.4%）。大多数死亡人员来自美国陆军特种作战司令部（67.6%），其次是海军特种作战司令部（16.0%）、空军特种作战司令部（9.3%）和海军陆战队特种作战司令部（7.2%）。在 54.6%因骑乘作战中受伤而死亡的人员中，大多数人死于地面车辆（53.7%），其次是旋转翼（37.3%）和固定翼（9.0%）飞机。死亡方式主要是凶杀（66.0%）和意外（30.5%），其次是自然（2.1%）、自杀（0.8%）和不明（0.7%）。具体的凶杀死亡原因是枪伤（43.7%）、爆炸伤（42.2%）、多发/钝器伤（13.8%）和其他（0.2%）。具体的意外死亡原因是多发/钝器伤（80.7%）、爆炸伤（6.4%）、枪伤（0.5%）和其他（12.3%）。在意外多发/钝器伤死亡人员中，受伤机制主要是飞机失事（62.9%），尤其是旋转翼（68.4%）。
大多数 USSOCOM 死亡人员在国外的院外环境中因伤死亡。为了提高全球军事活动中的生存率，领导层必须继续优化院外救护能力，并制定策略，使患者能够迅速获得高级复苏和外科治疗。
流行病学，四级；治疗学，四级。
