Le TD, et al. - In this retrospective cohort study, the researchers described nonbattle injury (NBI) among service members deployed to Iraq and Afghanistan, quantify absolute numbers of NBIs and proportion of NBIs within the Department of Defense Trauma Registry, as well as documented the characteristics of this injury category. In the result, they found approximately one-third of injuries during the Iraq and Afghanistan wars resulted from NBI, and the proportion of NBIs was steady for 12 years. During military operations, understanding the possible causes of NBI could be helpful to target protective measures and safety interventions, thereby conserving fighting strength on the battlefield.

Methods

• From January 1, 2003, through December 31, 2014, data from the Department of Defense Trauma Registry on 29,958 service members injured in Iraq and Afghanistan were obtained.
• By battle injury and NBI, injury incidence, patterns, and severity were characterized.
• After that, trends in NBI were modeled using time series analysis with autoregressive integrated moving average and the weighted moving average method.
• From January 1, 2003, to December 31, 2014, statistical analysis was performed.
• Proportion of NBIs and the changes in NBI over time were the primary outcomes.

Results

• As per data, among 29,958 casualties (battle injury and NBI) studied, 29,003 were in men and 955 were in women; the median age at injury was 24 years (interquartile range, 21-29 years).
• Researchers reported that nonbattle injury caused 34.1% of total casualties (n = 10,203) and 11.5% of all deaths (206 of 1788).
• It was observed in the findings that rates of NBI were higher among women than among men (63.2% [604 of 955] vs 33.1% [9599 of 29,003]; P < .001) and in Operation New Dawn (71.0% [298 of 420]) and Operation Iraqi Freedom (36.3% [6655 of 18,334]) compared with Operation Enduring Freedom (29.0% [3250 of 11,204]) (P < .001).
• The data presented in this work showed a higher proportion of NBIs occurred in members of the Air Force (66.3% [539 of 810]) and Navy (48.3% [394 of 815]) than in members of the Army (34.7% [7680 of 22,154]) and Marine Corps (25.7% [1584 of 6169]) (P < .001).
• Falls (2178 [21.3%]), motor vehicle crashes (1921 [18.8%]), machinery or equipment accidents (1283 [12.6%]), blunt objects (1107 [10.8%]), gunshot wounds (728 [7.1%]), and sports (697 [6.8%]), causing predominantly blunt trauma (7080 [69.4%]) were the included leading mechanisms of NBI.
• It was noted that the trend in proportion of NBIs did not decrease over time, remaining at approximately 35% (by weighted moving average) after 2006 and approximately 39% by autoregressive integrated moving average.
• The autoregressive integrated moving average model estimated that the proportion of NBIs from 2015 to 2022 would be approximately 41.0% (95% CI, 37.8%-44.3%) assuming stable battlefield conditions.