Uniformed Services University of the Health Sciences, Bethesda, MD; and 40th Forward Resuscitation and Surgical Detachment, 627 Hospital Center, 1st Medical Brigade, Fort Carson, CO.
Emergency Medicine, Madigan Army Medical Center, Joint Base Lewis McChord, WA.
Med J (Ft Sam Houst Tex). 2022 Apr-Jun;Per 22-04-05-06(Per 22-04-05-06):3-9.
During large scale combat operations, rising numbers of casualties will likely outstrip in-theater US military medical hospitalization assets. This highlights the importance of identifying those casualties who can return to the fight in order to minimize further medical resource depletion. We describe specific characteristics of casualties returned to duty without requiring evacuation from theater during recent major combat operations.
We conducted a secondary analysis of previously published data from the Department of Defense Trauma Registry during 01 January 2007 through 17 March 2020. We included all adult US military casualties. We categorized casualties according to documented disposition, namely, return to duty within 72 hours without evacuation from theater, return to duty greater than 72 hours without evacuation from theater, and all other casualties.
Of 10,182 adult US military casualties, 3,856 (37.9%) returned to duty within 72 hours without evacuation from theater and 220 (2.2%) returned to duty in greater than 72 hours without evacuation from theater. The cohort that rapidly returned to duty had a lower median injury severity score (2) than casualties returning to duty in greater than 72 hours (4) and those evacuated from theater (11). Notably higher proportions of casualties evacuated from theater sustained injuries to the face, thorax, abdomen, and extremities. Modes of transportation were similar across all three groups, though casualties undergoing evacuation from theater were more likely to undergo air transportation during the spectrum of their medical care.
Most combat casualties returning to duty without evacuation from theater did so within 72 hours of hospitalization. Casualties not requiring evacuation from theater were less likely to sustain injuries to the face, thorax, abdomen, and extremities.
在大规模作战行动中，伤员人数的增加可能超过战区内美国军事医疗机构的收治能力。这凸显了确定那些能够重返战斗岗位的伤员的重要性，以尽量减少对医疗资源的进一步消耗。我们描述了在最近的主要作战行动中，无需从战区撤离即可返回现役的伤员的具体特征。
我们对 2007 年 1 月 1 日至 2020 年 3 月 17 日期间国防部创伤登记处公布的先前数据进行了二次分析。我们纳入了所有成年美军伤员。根据记录的处置情况，我们将伤员分为以下几类：72 小时内无需从战区撤离即可返回现役、72 小时以上无需从战区撤离即可返回现役和其他所有伤员。
在 10182 名成年美军伤员中，3856 名（37.9%）在 72 小时内无需从战区撤离即可返回现役，220 名（2.2%）在 72 小时以上无需从战区撤离即可返回现役。快速返回现役的伤员队列的中位数损伤严重程度评分（2 分）低于 72 小时以上返回现役的伤员（4 分）和从战区撤离的伤员（11 分）。从战区撤离的伤员中，有更高比例的伤员面部、胸部、腹部和四肢受伤。在所有三组伤员中，转运模式相似，尽管从战区撤离的伤员在医疗护理过程中更有可能通过空运转运。
大多数无需从战区撤离即可返回现役的伤员在住院后 72 小时内返回现役。无需从战区撤离的伤员不太可能面部、胸部、腹部和四肢受伤。
