Severe XXXX During the Iraq and Afghanistan Conflicts.

@entity1 @entity542 @entity772 @entity23806
BACKGROUND: Much has been written about injuries sustained by US and coalition soldiers during the Global War on Terrorism campaigns. However, injuries to civilians, including @entity1 , have been less well documented. OBJECTIVE: To describe the epidemiologic features and outcomes associated with isolated severe @entity542 in @entity1 during Operations Enduring Freedom and Iraqi Freedom (OEF and @entity23806 ). METHODS: A retrospective review of @entity1 (<18 years old) in the Joint Theater Trauma Registry with isolated @entity542 (defined as an Abbreviated Injury Score Severity Code >3) and treated at a US combat support hospital in Iraq or Afghanistan (2004-2012). The primary outcome was in-hospital mortality. RESULTS: We identified 647 @entity1 with severe isolated @entity542 : 337 from OEF, 268 from @entity23806 , and 42 nontheater specific. Most were @entity1 (76%; median age = 8 years). Penetrating injuries were most common (60.6%). Overall, 330 (51%) @entity1 underwent a craniotomy/craniectomy; 156 (24.1%) succumbed to their injuries. Admission Glasgow @entity772 Score was predictive of survival among the entire cohort and each of the individual conflicts. Male sex also significantly increased the odds of survival for the entire group and OEF, but not for @entity23806 . Closed- @entity542 improved the predictive ability of our model but did not reach statistical significance as an independent factor. CONCLUSION: This is the largest study of combat-related isolated @entity542 in @entity1 . Admission Glasgow @entity772 Score and male sex were found to be predictive of survival. Assets to comprehensively care for the pediatric @entity1 should be established early in future conflicts. ABBREVIATIONS: CI, confidence intervalGCS, Glasgow @entity772 ScoreICP, intracranial pressureIED, improvised explosive deviceJTTR, Joint Theater Trauma RegistryLN, local nationalMTF, military treatment facilityOEF, Operation Enduring FreedomOIF, Operation Iraqi Freedom.
