title: Vascular Injuries in Combat-Specific Soldiers during Operation Iraqi Freedom and Operation Enduring Freedom.
abstract: BACKGROUND
  This study sought to identify vascular injury patterns among combat-specific cavalry scout personnel within the Iraq and Afghanistan Wars.
  
  
  METHODS
  The Armed Forces Medical Examiner System and Joint Theater Trauma Registry were queried for all injuries with the cavalry scout designation from 2003 to 2011, including those both wounded in action (WIA) and killed in action (KIA). A description of vascular injury, combat causality care statistics, mechanism of injury, and demographic data were recorded.
  
  
  RESULTS
  Sixteen percent (n = 111) of the 701 cavalry scouts with a combat wound sustained a vascular injury. Among cavalry scouts sustaining vascular injuries, 69% were caused by an explosive mechanism of injury, 63% were KIA, and 29% had a major extremity amputation. Cavalry scout soldiers with a vascular injury were significantly more likely to result from explosion (P < 0.0001), be KIA (P < 0.0001), and occur in Iraq (P < 0.0001). The rate of noncompressible arterial injury was 65%. WIA cavalry scout soldiers with a compressible vascular injury with clear documentation of prehospital tourniquet utilization arrived at a Medical Treatment Facility in 67% of cases with a tourniquet in place. Of these transported with a prehospital tourniquet 83% survived.
  
  
  CONCLUSIONS
  The high rates of KIA and extremity amputation among cavalry scout soldiers with a vascular injury denotes the lethality of these combat injuries. Uniformly equipping soldiers with battlefield tourniquets and educating them on their prehospital use might improve the survivorship of those servicemembers sustaining a compressible vascular injury.
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX. Electronic address: dunnjohnc@gmail.com.
authors.forename: John C
authors.initials: JC
authors.lastname: Dunn
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Kusnezov
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX; Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Schoenfeld
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX.
authors.forename: Justin D
authors.initials: JD
authors.lastname: Orr
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cook
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Belmont
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects / Q000401:mortality; D001158:Arteries / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001753:Blast Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004632:Emergency Medical Services / Q000379:methods*; D005121:Extremities / Q000098:blood supply*; D006801:Humans; D007493:Iraq; D054542:Iraq War, 2003-2011; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D012042:Registries; D012307:Risk Factors; D014111:Tourniquets / Q000009:adverse effects; D016896:Treatment Outcome; D014481:United States; D057772:Vascular System Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D055815:Young Adult