title: Disease and nonbattle injuries sustained by a U.S. Army Brigade Combat Team during Operation Iraqi Freedom.
abstract: BACKGROUND
  A longitudinal cohort analysis of disease nonbattle injuries (DNBI) sustained by a large combat-deployed maneuver unit has not been performed.
  
  
  METHODS
  A descriptive analysis was undertaken to evaluate for DNBI casualty care statistics incurred by a U.S. Army Brigade Combat Team (BCT) during a counterinsurgency campaign of Operation Iraqi Freedom.
  
  
  RESULTS
  Of the 4,122 soldiers deployed, there were 1,324 DNBI with 5 (0.38%) deaths, 208 (15.7%) medical evacuations (MEDEVAC), and 1,111 (83.9%) returned to duty. The DNBI casualty rate for the BCT was 257.0/1,000 soldier combat-years. Females, compared with males, had a significantly increased incidence rate ratio for becoming a DNBI casualty 1.67 (95% CI 1.37, 2.04). Of 47 female soldiers receiving MEDEVAC 35 (74%) were for pregnancy-related issues. Musculoskeletal injuries (50.4%) and psychiatric disorders (23.3%) were the most common body systems involved with DNBI casualties. Among the BCT cohort the psychiatric DNBI casualty rate and suicide rate were 59.8 and 0.58 per 1,000 soldier combat-years. The BCT cohort incidence rates for common musculoskeletal injuries per 1,000 combat-years were as follows: ankle sprain 15.3, anterior cruciate ligament rupture 3.3 and shoulder dislocation 1.2.
  
  
  CONCLUSIONS
  Musculoskeletal injuries and psychiatric disorders accounted for 74% of the total DNBI casualties, and 43% of the DNBI casualties requiring subsequent MEDEVAC. The BCT cohort had a suicide rate nearly four times greater than previously reported, and selected musculoskeletal injury incidence rates were fivefold greater than the general population.
authors.affiliation: William Beaumont Army Medical Center, El Paso, TX 79920, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Belmont
authors.forename: Gens P
authors.initials: GP
authors.lastname: Goodman
authors.forename: Brian
authors.initials: B
authors.lastname: Waterman
authors.forename: Kent
authors.initials: K
authors.lastname: DeZee
authors.forename: Rob
authors.initials: R
authors.lastname: Burks
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D008889:Military Personnel; D009141:Musculoskeletal System / Q000293:injuries*; D016012:Poisson Distribution; D011247:Pregnancy; D013405:Suicide / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*