title: Derivation of candidates for the combat casualty critical care (C4) database.
abstract: OBJECTIVE
  To describe the development of the Combat Casualty Critical Care Database, a comprehensive database of critically injured combat casualties to identify potentially modifiable risk factors for morbidity and mortality in this population.
  
  
  METHODS
  The Department of Defense's Joint Theater Trauma Registry was queried for all combat casualties injured from February 1, 2002 through February 1, 2011. The search was limited to patients who required admission to the intensive care unit and survived to be evacuated to Landstuhl Regional Medical Center.
  
  
  RESULTS
  The query yielded 6,011 patients. The mean age was 25.7 ± 6.2 years. The majority of patients were male (98.3%), injured in Iraq (80%) and were members of the U. S. Army (72.6%). Most patients (58.0%) had an injury severity score in the lowest severity category (0-15). The mortality rate was 1.8%. The median day of death after injury (interquartile range) was 6 (3-14).
  
  
  CONCLUSIONS
  We identified a cohort of critically wounded combat casualties that encompasses the majority of such patients injured in the course of the wars in Iraq and Afghanistan. When this database is fully populated, rigorous epidemiologic analysis will seek to identify factors associated with morbidity and mortality to improve future care.
authors.affiliation: San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234-6200.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Stewart
authors.affiliation: U.S. Air Force Center for Sustainment of Trauma and Readiness Skills, 22 South Greene Street, Baltimore, MD 21201.
authors.forename: Raymond
authors.initials: R
authors.lastname: Fang
authors.affiliation: San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234-6200.
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Cannon
authors.affiliation: Landstuhl Regional Medical Center, CMR 402, Box 1824, APO, AE 09180.
authors.forename: David H
authors.initials: DH
authors.lastname: Zonies
authors.affiliation: San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234-6200.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Morrow
authors.affiliation: U. S. Army Institute of Surgical Research, 3698 Chambers Pass STE B, JBSA Fort Sam Houston, TX 78234-7767.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Orman
authors.affiliation: Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600.
authors.forename: James D
authors.initials: JD
authors.lastname: Oliver
authors.affiliation: Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Abbott
authors.affiliation: U. S. Army Institute of Surgical Research, 3698 Chambers Pass STE B, JBSA Fort Sam Houston, TX 78234-7767.
authors.forename: John A
authors.initials: JA
authors.lastname: Jones
authors.affiliation: U. S. Army Institute of Surgical Research, 3698 Chambers Pass STE B, JBSA Fort Sam Houston, TX 78234-7767.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Chung
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D009017:Morbidity / Q000639:trends; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*