Causes of death in US Special Operations Forces in the global war on terrorism - 2001-2004
Causes of death in US Special Operations Forces in the global war on terrorism - 2001-2004
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DOI：
10.1097/01.sla.0000259433.03754.98
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发表时间：
2007-06-01
影响因子：
9
通讯作者：
Butler, Frank K.
中科院分区：
文献类型：
--
作者：
Holcomb, John B.;McMullin, Neil R.;Butler, Frank K.
背景资料：有效的战斗创伤管理策略取决于死亡的流行病学在battley.Methods的理解：军事医疗专家小组审查了照片和尸检和治疗记录的所有特种作战部队（SOF）谁死在2001年10月至2004年11月（n = 82）。致命伤口被分类为无法存活或可能存活。考虑到受伤时的培训和可用设备。进行了结构化分析，以确定设备，培训，或研究的要求，以改善未来outcome.Results：五（6%）的82名伤亡人员在飞机失事中死亡，他们的尸体在海上丢失，尸检已进行所有其他77名士兵。19人死亡，包括海上死亡，都是非战斗人员，其他人都与战斗有关。爆炸（43%），枪伤（28%），飞机事故（23%）和钝伤（6%）造成的死亡。82例死亡中有70例（85%）被归类为无法存活; 12例死亡（15%）被归类为可能存活。在有可能存活的损伤的患者中，确定了16种死亡原因：8种（50%）躯干出血，3种（19%）可压缩出血，2种（13%）适合止血带的出血，以及张力性气胸、气道阻塞和败血症各1种（6%）。非存活性损伤的人群比潜在存活性损伤的人群受伤更严重。结构化分析确定了改进的方法，躯干出血控制作为一个主要的研究requirement.Conclusions：在现代战场上的大多数死亡是无法生存的。改进的静脉或腔内非压迫性止血方法结合快速后送至手术可能会提高生存率。
Background: Effective combat trauma management strategies depend upon an understanding of the epidemiology of death on the battlefield.Methods: A panel of military medical experts reviewed photographs and autopsy and treatment records for all Special Operations Forces (SOF) who died between October 2001 and November 2004 (n = 82). Fatal wounds were classified as nonsurvivable or potentially survivable. Training and equipment available at the time of injury were taken into consideration. A structured analysis was conducted to identify equipment, training, or research requirements for improved future outcomes.Results: Five (6%) of 82 casualties had died in an aircraft crash, and their bodies were lost at sea; autopsies had been performed on all other 77 soldiers. Nineteen deaths, including the deaths at sea were noncombat; all others were combat related. Deaths were caused by explosions (43%), gunshot wounds (28%), aircraft accidents (23%), and blunt trauma (6%). Seventy of 82 deaths (85%) were classified as nonsurvivable; 12 deaths (15%) were classified as potentially survivable. Of those with potentially survivable injuries, 16 causes of death were identified: 8 (50%) truncal hemorrhage, 3 (19%) compressible hemorrhage, 2 (13%) hemorrhage amenable to tourniquet, and 1 (6%) each from tension pneumothorax, airway obstruction, and sepsis. The population with nonsurvivable injuries was more severely injured than the population with potentially survivable injuries. Structured analysis identified improved methods of truncal hemorrhage control as a principal research requirement.Conclusions: The majority of deaths on the modem battlefield are nonsurvivable. Improved methods of intravenous or intracavitary, noncompressible hemostasis combined with rapid evacuation to surgery may increase survival.