Factors linked to, lessons learned from reduced mortality during military conflicts

Editor's Note

The increased use of tourniquets, blood transfusions, and reduced time to surgical treatment (ie, within 1 hour) were the main factors that reduced mortality 44.2% during military conflicts in Afghanistan and Iraq, this study finds.

From October 2001 through December 2017, survival increase three-fold among the most critically injured. As of December 31, 2017, the overall case-fatality rate in Afghanistan was 8.6%, down from 20.0% in October 2001; in Iraq, it was 10.1%, down from 20.4% in March 2003.

At the same time, survival with an Injury Severity Score of 25 to 75 (critical) increased from 8.9% to 32.9% in Iraq, and from 2.2% to 39.9% in Afghanistan.

Critically injured casualties accounted for 16.2% of casualties and 90.1% of deaths overall in Afghanistan, and 16.4% of casualties and 90.5% of deaths in Iraq.

Many medical advances have been propagated during warfare. Key lessons learned from Iraq and Afghanistan are that military advancements in hemorrhage control, blood replacement, and reduced time to surgical treatment increase survival in trauma victims, the authors say.