title: Military trauma care in Birmingham: observational study of care requirements and resource utilisation.
abstract: BACKGROUND
  The Royal Centre for Defence Medicine is located at University Hospitals Birmingham (UHB). Since 2001 all UK military casualties injured on active duty have been repatriated here for their initial treatment. This service evaluation was performed to quantify the work undertaken, with the aim of providing a snapshot of a year's military trauma work in order to inform the delivery of trauma care in both the military and civilian setting.
  
  
  METHODS
  Military patients admitted with traumatic injuries over a 12-month period were identified and the hospital notes and electronic records reviewed. Data were collected focusing on three areas - the details of the injury, information about the in-patient admission, and surgical interventions performed.
  
  
  RESULTS
  A total of 388 patients were used in the analysis. Median total length of stay was 10.5 days (IQR: 4-26, range: 0-137 days), and a median 6.0 days (IQR: 3.0-11.0, range: 1-49 days) was spent on intensive care by 125 patients. Surgical intervention was required for 278 (71.6%) patients, with a median of 2.0 operations (IQR: 1.0-4.0, range: 1-27) or 170 min (IQR: 90.0-570.0, range 20-4735 min) operating time per patient. 77% of these patients had their first procedure within 24h of arrival. Improvised explosives accounted for 50.5% of injuries seen. Spearman rank correlation between New Injury Severity Score with length of stay demonstrated significant correlation (p<0.001), with a coefficient of 0.640. A model predicting length of stay based on New Injury Severity Score was devised for patients with battle injuries.
  
  
  CONCLUSIONS
  This report of 12 months work at UHB demonstrates the service commitment to these casualties, describing the burden of care and resource requirements for military trauma patients.
authors.affiliation: Hull & East Yorkshire Hospitals, Yorkshire, United Kingdom. Electronic address: drpcjackson@gmail.com.
authors.forename: Philippa C
authors.initials: PC
authors.lastname: Jackson
authors.forename: Mark
authors.initials: M
authors.lastname: Foster
authors.forename: Anton
authors.initials: A
authors.lastname: Fries
authors.forename: Steven L A
authors.initials: SL
authors.lastname: Jeffery
mesh_terms: D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000191:economics / Q000401:mortality / Q000601:surgery*; D003422:Critical Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008887:Military Medicine / Q000191:economics; D008889:Military Personnel; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D010360:Patient Transfer / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D006113:United Kingdom / Q000453:epidemiology; D014857:Warfare; D014949:Wounds, Nonpenetrating / Q000191:economics / Q000401:mortality / Q000601:surgery*; D014950:Wounds, Penetrating / Q000191:economics / Q000401:mortality / Q000601:surgery*