Analysis of injury patterns and roles of care in US and Israel militaries during recent conflicts: Two are better than one.
BACKGROUND
As new conflicts emerge and enemies evolve, military medical organizations worldwide must adopt the "lessons learned." In this study, we describe roles of care (ROCs) deployed and injuries sustained by both US and Israeli militaries during recent conflicts. The purpose of this collaborative work is facilitate exchange of medical data among allied forces in order to advance military medicine and facilitate strategic readiness for future military engagements that may involve less predictable situations of evacuation and care, such as prolonged field care.


METHODS
This retrospective study was conducted for the periods of 2003 to 2014 from data retrieved from the Department of Defense Trauma Registry and the Israel Defense Force (IDF) Trauma Registry. Comparative analyses included ROC capabilities, casualties who died of wounds, as well as mechanism of injury, anatomical wound distribution, and Injury Severity Score of US and IDF casualties during recent conflicts.


RESULTS
Although concept of ROCs was similar among militaries, the IDF supports increased capabilities at point of injury and Role 1 including the presence of physicians, but with limited deployment of other ROCs; conversely, the US maintains fewer capabilities at Role 1 but utilized the entire spectrum of care, including extensive deployment of Roles 2/2+, during recent conflicts. Casualties from US forces (n = 19,005) and IDF (n = 2,637) exhibited significant differences in patterns of injury with higher proportions of casualties who died of wounds in the US forces (4%) compared with the IDF (0.6%).


CONCLUSIONS
As these data suggest deployed ROCs and injury patterns of US and Israeli militaries were both conflict and system specific. We envision that identification of discordant factors and common medical strategies of the two militaries will enable strategic readiness for future conflicts as well as foster further collaboration among allied forces with the overarching universal goal of eliminating preventable death on the battlefield.
From the US Army Institute of Surgical Research, JBSA, Fort Sam Houston, Texas (B.A., E.A.M.-S., T.D.L., L.C.C., J.C.W., K.R.G.); Department of Surgery "A," Meir Medical Center, Kfar Saba and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (A.B., H.P.); Israel Defense Forces Medical Corps (IDF-MC), Ramat Gan, Israel (A.B., A.Y., B.T., D.D., E.G.); Department of Military Medicine, Hebrew University, Jerusalem, Israel (B.T.); The Geneva Foundation, Tacoma, Washington (B.A.).
Ben
B
Antebi
Avi
A
Benov
Elizabeth A
EA
Mann-Salinas
Tuan D
TD
Le
Leopoldo C
LC
Cancio
Joseph C
JC
Wenke
Haim
H
Paran
Avraham
A
Yitzhak
Bader
B
Tarif
Kirby R
KR
Gross
David
D
Dagan
Elon
E
Glassberg
D000328:Adult; D000068337:Armed Conflicts; D005260:Female; D006801:Humans; D000070516:Intersectoral Collaboration; D007557:Israel; D008297:Male; D008887:Military Medicine / Q000379:methods; D008889:Military Personnel; D012042:Registries; D012189:Retrospective Studies; D014481:United States; D014947:Wounds and Injuries / Q000145:classification / Q000628:therapy*; D055815:Young Adult