Introduction
Medical information systems during past military deployments had limited injury surveillance
capability as data were not accessible during deployments and did not capture causes
of injury. This paper describes nonbattle injury (NBI) results from an ongoing surveillance
program that identifies injury occurrences and causes during deployments for Operations
Iraqi Freedom (Iraq) and Enduring Freedom (Afghanistan).
Methods
U.S. Army soldiers medically air evacuated from Iraq (March 2003–December 2006) or
Afghanistan (October 2001–December 2006) were identified from air evacuation records
that provided demographics, casualty type, diagnosis, and patient history. For NBI
cases, the patient history was used to identify and code injury cause, incident circumstances,
and body region. Descriptive statistics were used to describe and compare NBIs evacuated
from Iraq and Afghanistan.
Results
In all, 27,563 soldiers in Iraq and 4165 in Afghanistan were air evacuated. NBIs accounted
for 35% and 36% of cases, respectively, and were the largest single category of evacuations
for both operations. Distributions for leading categories of NBI diagnosis (fracture,
inflammation/pain, and dislocation) and body region (back, knee, and wrist/hand) were
similar for both operations. Leading NBI causes were the same for both operations—sports/physical
training (19%–21%), falls/jumps (18%), and motor vehicle–related incidents (12%–16%)—but
the proportion of motor vehicle incidents was higher in Iraq (p<0.001).
Conclusions
Routinely collected air evacuation records provided the basis for ongoing injury surveillance
for Iraq and Afghanistan. NBI was the largest category of evacuations from both operations.
Leading NBI causes were similar to those identified for previous deployments and many
should be preventable.
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