Combat wounds in Iraq and Afghanistan from 2005 to 2009

The article of record as published may be found at http://dx.doi.org/10.1097/TA.0b013e318250bfb4The importance of characterizing the incidence and character of war injuries, as well their precipitating mechanisms, has been recognized since the 19th century, when such an endeavor was conducted at the end of the American Civil War. Since that time, catalogues of the types of combat wounds sustained by American military personnel in each major conflict have been published to varying degrees. At the present time, the US Armed Forces are engaged in the most prolonged military conflict in this nation’s history. Moreover, the two fronts of the eponymous Global War on Terror, the Iraq and Afghanistan wars, have not only produced more combat-related casualties since the Vietnam era but also witnessed the wide-scale use of protective equipment for both military personnel and vehicles, as well as irregular enemy tactics, which have resulted in increased wound severity and concomitant disability.Approved for public release; distribution is unlimited

Combat-related gunshot wounds in the United States military: 2000-2009 (cohort study)

Introduction: The armed forces of the United States are engaged in the longest conflict in their history. No prior works have described the incidence or epidemiology of gunshot wounds in the U.S. military. Methods: All combat-related gunshot wounds sustained by uniformed service members in the years 2000-2009 were identified using the Defense Medical Epidemiology Database. Demographic information for all individuals identified as having sustained gunshot injuries was obtained and like data was captured for the entire military population serving in the same time-period. Raw unadjusted incidence rates were calculated for gunshot wounds within the entire demographic, as well as for the subcategories of sex, military rank, branch of service, and age. Adjusted incidence rate ratios were also calculated via multivariate Poisson regression analysis, using subcategories with the lowest unadjusted incidence rates as referents. Results: We identified 4693 gunshot wounds within a population of 13,813,333 person-years for an overall incidence of 0.34 per 1000 person-years. Marine Corps service demonstrated the highest unadjusted incidence rate at 0.68 per 1000 person-years. Male sex, Junior Enlisted rank, Army and Marine Corps service, and ages 20-29 demonstrated significant adjusted incidence rate ratios and maintained unadjusted incidence rates above the population mean. Conclusions: Male sex, Junior Enlisted rank, Army and Marine Corps service, and ages 20-29 were identified as significant independent risk factors for war-related gunshot injuries. This investigation is the first to report on the incidence and epidemiology of gunshot wounds and includes the largest cohort of individuals to sustain such injuries in the literature

Incidence and epidemiology of spinal cord injury within a closed American population: the United States military (2000–2009)

The objective of this study was to characterize the incidence of spinal cord injury (SCI) within the population of the United States military from 2000–2009. This investigation also sought to define potential risk factors for the development of SCI