http://www.empr.com/11-of-combat-wounded-have-spinal-injuries/article/312216/

~11% of Combat Wounded Have Spinal Injuries 

~11 Percent of Combat Wounded Have Spinal Injuries

(HealthDay News) – Spine injuries account for >11% of all casualties among U.S. combat-wounded military in Iraq and Afghanistan, according to a study published in the Sept. 15 issue of Spine.

Andrew J. Schoenfeld, MD, from the Texas Tech University Health Sciences Center in El Paso, and colleagues conducted a retrospective analysis of casualty records from the Department of Defense Trauma Registry for 2005–2009 to assess the incidence and epidemiology of combat-related spinal injuries for the wars in Afghanistan and Iraq.

The researchers identified 872 casualties with spine injuries among a total of 7,877 combat wounded (11.1%), with a mean age of 26.6 years. The most common injury morphology was spine fractures, accounting for 83% of all spinal wounds. The incidence of combat-related spinal trauma was 4.4 per 10,000, while spine fracture incidence was 4 per 10,000. The rate of spinal cord injuries was 4 per 100,000. The incidence of spinal cord injuries was increased in Afghanistan (incidence rate ratio [IRR], 1.96), among Army personnel (IRR, 16.85), and in 2007 (IRR, 1.9). Gunshot-related spinal injuries were significantly more likely to occur in Iraq than Afghanistan (17% vs. 10%; P=0.02).

"The incidence of spine trauma in modern warfare exceeds reported rates from earlier conflicts," the authors write.

Relevant financial activities outside the submitted work were disclosed.

http://www.ncbi.nlm.nih.gov/pubmed/23759821

Spine (Phila Pa 1976). 2013 Sep 15;38(20):1770-8. doi: 10.1097/BRS.0b013e31829ef226.

Spinal injuries in United States military personnel deployed to Iraq and Afghanistan: an epidemiological investigation involving 7877 combat casualties from 2005 to 2009.

Schoenfeld AJ, Laughlin MD, McCriskin BJ, Bader JO, Waterman BR, Belmont PJ Jr.

Author information

Abstract

STUDY DESIGN:

Retrospective analysis of a prospective data set.

OBJECTIVE:

Determine the incidence and epidemiology of combat-related spinal injuries for the wars in Afghanistan and Iraq.

SUMMARY OF BACKGROUND DATA:

Recent studies have identified a marked increase in the rate of combat-related spine trauma among casualties in Afghanistan and Iraq. Limitations in these previous works, however, limit their capacity for generalization.

METHODS:

A manual search of casualty records stored in the Department of Defense Trauma Registry was performed for the years 2005 to 2009. Demographic information, nature of spinal wounding, injury mechanism, concomitant injuries, year, and location of injury were recorded for all soldiers identified as having sustained combat-related spine trauma. Incidence rates were constructed by comparing the frequencies of spine casualties against defense manpower deployment data. Multivariate Poisson regression was used to identify statistically significant factors associated with spinal injury.

RESULTS:

In the years 2005 to 2009, 872 (11.1%) casualties with spine injuries were identified among a total of 7877 combat wounded. The mean age of spine casualties was 26.6 years. Spine fractures were the most common injury morphology, comprising 83% of all spinal wounds. The incidence of combat-related spinal trauma was 4.4 per 10,000, whereas that of spine fractures was 4.0 per 10,000. Spinal cord injuries occurred at a rate of 4.0 per 100,000. Spinal cord injuries were most likely to occur in Afghanistan (incident rate ratio: 1.96; 95% confidence interval: 1.68-2.28), among Army personnel (incident rate ratio: 16.85; 95% confidence interval: 8.39-33.84), and in the year 2007 (incident rate ratio: 1.90; 95% confidence interval: 1.55-2.32). Spinal injuries from gunshot were significantly more likely to occur in Iraq (17%) than in Afghanistan (10%, P = 0.02).

CONCLUSION:

The incidence of spine trauma in modern warfare exceeds reported rates from earlier conflicts. The study design and population size may enhance the capacity for generalization of our findings.

LEVEL OF EVIDENCE:

3.

PMID:

 

23759821

 

[PubMed - in process]