The Effect of Prehospital Transport Time, Injury Severity, and Blood Transfusion on Survival of US Military Casualties in Iraq

ABSTRACTBACKGROUNDReducing time from injury to care can optimize trauma patient outcomes. A previous study of prehospital transport of US military casualties during the Afghanistan conflict demonstrated the importance of time and treatment capability for combat casualty survival.METHODSA retrospective descriptive analysis was conducted to analyze battlefield data collected on US military combat casualties during the Iraq conflict from March 19, 2003 to August 31, 2010. All casualties were analyzed by mortality outcome (killed in action, died of wounds, case fatality rate) and compared to Afghanistan conflict. Detailed data for those who underwent prehospital transport were analyzed for effects of transport time, injury severity, and blood transfusion on survival.RESULTSFor the total population, percent killed in action (16.6% vs 11.1%), percent died of wounds (5.9% vs 4.3%), and case fatality rate (10.0 vs 8.6) were higher for Iraq vs Afghanistan (P

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