RT Journal Article
SR Electronic
T1 Ten-year reduction in thoracic injury-related mortality among Israel Defense Forces soldiers
JF BMJ Military Health
JO BMJ Mil Health
FD British Medical Journal Publishing Group
SP e001986
DO 10.1136/bmjmilitary-2021-001986
A1 Jacob Chen
A1 A M Tsur
A1 R Nadler
A1 E Beit Ner
A1 A Sorkin
A1 I Radomislensky
A1 K Peleg
A1 R Ben Avi
A1 G Shushan
A1 E Glassberg
A1 A Benov
YR 2021
UL http://militaryhealth.bmj.com/content/early/2021/12/28/bmjmilitary-2021-001986.abstract
AB Introduction This study aims to describe injury patterns, prehospital interventions and mortality rates of combat-related thoracic injuries during the past decade among Israel Defense Forces (IDF) soldiers before and after implementation of the 2012 IDF-Military Corps ‘My Brother’s Keeper’ plan which included the publication of clinical practice guidelines (CPGs) for thoracic injuries, emphasis on adequate torso protection, introduction of modern life-saving procedures and encouragement of rapid evacuation.Methods The IDF prehospital trauma registry was reviewed to identify all patients who sustained thoracic injuries from January 2006 to December 2017. IDF soldiers who were injured, died of wounds or killed in action (KIA) were included. These were cross-referenced with the Israel National Trauma Registry. The periods before and after the plan were compared.Results 458 (12.3%) of 3733 IDF soldiers wounded on the battlefield sustained combat-related thoracic injuries. The overall mortality was 44.3% before the CPG and 17.3% after (p<0.001). Most were KIA: 97% (95 of 98) died by 30 June 2012, and 83% (20 of 24) after (p<0.001). Casualties treated with needle thoracostomy before and after CPG were 6.3% and 18.3%, respectively (p=0.002). More tube thoracostomies were performed after June 2012 (16.1% vs 5.4%, p=0.001). Evacuation was faster after June 2012 (119.4 min vs 560.8 min, p<0.001), but the rates of casualties evacuated within 60 min were similar (21.1% vs 25%, p=0.617).Conclusions Among military casualties with thoracic injuries, the rate of life-saving interventions increased, evacuation time decreased and mortality dropped following the implementation of My Brother’s Keeper plan.Data are available upon reasonable request.