From the Joint Trauma System (R.S.K., E.L.M., J.C.J., J.T.H., J.M.G., S.A.S.), Defense Health Agency, Joint Base San Antonio-Fort Sam Houston, Texas; Uniformed Services University (R.S.K., E.L.M., H.T.H., J.M.G., S.A.S.), Bethesda, Maryland; Texas A&M University (R.S.K.), College Station, Texas; Armed Forces Medical Examiner System (E.L.M., H.T.H.), Defense Health Agency, Dover Air Force Base, Delaware; University of Texas (J.T.H., B.J.E.), San Antonio, Texas; University of Alabama (J.B.H.), Birmingham, Alabama; and United States Army Institute of Surgical Research (J.M.G.), Joint Base San Antonio-Fort Sam Houston, Texas.
J Trauma Acute Care Surg. 2021 Aug 1;91(2):375-383. doi: 10.1097/TA.0000000000003268.
Military operations vary by scope, purpose, and intensity, each having unique forces and actions to execute a mission. Evaluation of military operation fatalities guides current and future casualty care.
A retrospective study was conducted of all US military fatalities from Operation New Dawn in Iraq, 2010 to 2011. Data were obtained from autopsies and other records. Population characteristics, manner of death, cause of death, and location of death were analyzed. All fatalities were evaluated for concomitant evidence of underlying atherosclerosis. Nonsuicide trauma fatalities were also reviewed for injury severity, mechanism of death, injury survivability, death preventability, and opportunities for improvement.
Of 74 US military Operation New Dawn fatalities (median age, 26 years; male, 98.6%; conventional forces, 100%; prehospital, 82.4%) the leading cause of death was injury (86.5%). The manner of death was primarily homicide (55.4%), followed by suicide (17.6%), natural (13.5%), and accident (9.5%). Fatalities were divided near evenly between combatants (52.7%) and support personnel (47.3%), and between battle injury (51.4%) and disease and nonbattle injury (48.6%). Natural and suicide death was higher (p < 0.01, 0.02) among support personnel who were older (p = 0.05) with more reserve/national guard personnel (p = 0.01). Total population prevalence of underlying atherosclerosis was 18.9%, with more among support personnel (64.3%). Of 46 nonsuicide trauma fatalities, most died of blast injury (67.4%) followed by gunshot wound (26.1%) and multiple/blunt force injury (6.5%). The leading mechanism of death was catastrophic tissue destruction (82.6%). Most had nonsurvivable injuries (82.6%) and nonpreventable deaths (93.5%).
Operation New Dawn fatalities were exclusively conventional forces divided between combatants and support personnel, the former succumbing more to battle injury and the latter to disease and nonbattle injury including self-inflicted injury. For nonsuicide trauma fatalities, none died from a survivable injury, and 17.4% died from potentially survivable injuries. Opportunities for improvement included providing earlier blood products and surgery.
Therapeutic, level V and epidemiological, level IV.
军事行动的范围、目的和强度各不相同，每一种行动都有独特的力量和行动来执行任务。对军事行动伤亡的评估指导着当前和未来的伤员救治。
对 2010 年至 2011 年在伊拉克开展的“黎明行动”中的所有美军阵亡人员进行了回顾性研究。数据来自尸检和其他记录。分析了人口特征、死亡方式、死因和死亡地点。对所有死亡人员进行了潜在动脉粥样硬化的并发证据评估。还对非自杀性创伤死亡人员的伤害严重程度、死亡机制、伤害生存能力、死亡可预防性和改进机会进行了审查。
在 74 名美军“黎明行动”阵亡人员中（中位数年龄 26 岁；男性占 98.6%；常规部队占 100%；院外急救占 82.4%），死亡的主要原因是损伤（86.5%）。死亡方式主要是凶杀（55.4%），其次是自杀（17.6%）、自然（13.5%）和意外（9.5%）。死亡人员在战斗人员（52.7%）和支援人员（47.3%）之间以及战斗损伤（51.4%）和疾病及非战斗损伤（48.6%）之间几乎平分秋色。自然和自杀死亡在年龄较大（p=0.05）和后备役/国民警卫队人员较多的（p=0.01）支援人员中更高（p<0.01，0.02）。总人群中潜在动脉粥样硬化的患病率为 18.9%，支援人员中患病率更高（64.3%）。在 46 名非自杀性创伤死亡人员中，大多数死于爆炸伤（67.4%），其次是枪伤（26.1%）和多发/钝性伤（6.5%）。主要的死亡机制是灾难性组织破坏（82.6%）。大多数人都有不可生存的损伤（82.6%）和不可预防的死亡（93.5%）。
“黎明行动”中的阵亡人员全部为常规部队，分为战斗人员和支援人员，前者更多地死于战斗损伤，后者更多地死于疾病和非战斗损伤，包括自杀。对于非自杀性创伤死亡人员，没有一人死于可存活的损伤，17.4%的人死于可能存活的损伤。改进的机会包括更早地提供血液制品和手术。
治疗性，5 级；流行病学，4 级。
