title: The injury burden of recent combat operations: mortality, morbidity, and return to service of U.K. naval service personnel following combat trauma.
abstract: OBJECTIVE
  The study establishes the functional outcomes of service personnel injured in current conflicts by correlating data on initial injury to the findings of medical boards after trauma and reconstructive treatment. Data comprehensively include all casualties of the Royal Navy and Royal Marines and all functional outcomes.
  
  
  METHODS
  Details of all casualties from 2003 to 2010 taken from the Joint Theatre Trauma Registry and records of all medical boards relating to these personnel were analysed. Population at risk and probability of survival data were calculated.
  
  
  RESULTS
  There were 221 casualties: 54 (24%) were fatalities; of 167 survivors, 21 (9% of total) were medically discharged; 26 (12%) were placed in reduced fitness category and 120 (55%) returned to full duty. Casualty risk per year of operational service for Naval Service personnel was 4.6%. New injury severity score and functional outcome were closely correlated, with specific exceptions. There were 3 unexpected survivors and no unexpected fatalities. Extremity injuries predominate in survivors.
  
  
  CONCLUSIONS
  The Defence Medical Service (DMS) provides excellent trauma and rehabilitative care. The authors contend that this is a valid proxy for other larger coalition formations. Specific injury patterns have higher impact on functional outcomes; future research efforts should focus on these areas.
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine (RCDM), ICT Research Park, Vincent Drive, Edgbaston, Birmingham B15 2SQ, United Kingdom.
authors.forename: Jowan G
authors.initials: JG
authors.lastname: Penn-Barwell
authors.forename: Charles A
authors.initials: CA
authors.lastname: Fries
authors.forename: Philippa M
authors.initials: PM
authors.lastname: Bennett
authors.forename: Mark
authors.initials: M
authors.lastname: Midwinter
authors.forename: Adrian B
authors.initials: AB
authors.lastname: Baker
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel; D009017:Morbidity / Q000639:trends; D009043:Motor Activity / Q000502:physiology*; D011379:Prognosis; D020127:Recovery of Function; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D006113:United Kingdom / Q000453:epidemiology; D014857:Warfare; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation