Howard JT, et al. - Through a retrospective analysis of all US military casualties from October 2001 through December 2017, analyze trends in overall combat casualty statistics, experts intended to evaluate aggregate measures of injury and interventions, and to assume how mortality rates would have changed had the interventions not happened. From the early stages to later stages of the conflicts, in aggregate data for 56,763 casualties, the case-fatality rate (CFR) declined in Afghanistan and Iraq. Survival for critically injured casualties progressed from 2.2% to 39.9% and 8.9% to 32.9% in Afghanistan and Iraq, respectively. Simulations using data from 23,699 people from casualties revealed that without interventions evaluated, CFR would likely have been higher in Afghanistan and Iraq, which equated to 3,672 additional deaths, of which 1,623 were correlated with the interventions examined ie, 474 deaths correlated with the use of tourniquets, 873 with blood transfusion, and 275 with prehospital transport times. Hence, elevated use of tourniquets, blood transfusions, and more rapid prehospital transport were correlated with 44.2% of total mortality decline. Further, more critically injured casualties arrived in surgical care, with progressed survival, indicating improvements in prehospital and hospital care.