Impact of non-battle injuries among Army soldiers deployed to Iraq and Afghanistan, 2001-2009

Injury is the leading health problem among non-deployed Army soldiers. For deployed soldiers in Iraq and Afghanistan (2001-2006), injury unrelated to battle or hostile action (non-battle injury [NBI]) was the leading casualty type (34.8%) requiring medical air evacuation from the theater of operations.

PURPOSE. Determine the overall impact of serious non-battle injuries (fatal, hospitalized, and air evacuated) among Army soldiers deployed to Iraq and Afghanistan from 2001 to 2009.

METHODS. Casualty, hospitalization, and air evacuation records were used to identify soldiers with NBIs resulting in death, hospitalization, or medical air evacuation among soldiers deployed to Iraq and Afghanistan from 2001 to 2009. Casualty type, diagnosis, and cause of injury were identified from records.

RESULTS. Overall, 818 soldiers died (68.8/100,000 person-yrs), 8218 were hospitalized (69.9/10,000 person-years) and 17543 were air evacuated (14.7/1000 person-yrs) for NBIs. The combined NBI rate was 22.1/1,000 person-years. While BI was the leading category for fatalities (77.4%) and hospitalizations (23.1%), NBI was the second leading category for both (20.8% and 19.1%, respectively), followed by illness. NBI was the leading diagnosis category for air evacuations (34.1%). The leading cause of fatal and hospitalized NBIs was motor vehicle crashes (34.7% and 34.5%, respectively), while sports/exercise were the leading cause (22.2%) for air evacuated NBIs.

CONCLUSION. As the second leading casualty category for fatalities and hospitalizations, and the leading category for air evacuations, NBIs greatly impact the health, resources, and operational readiness of deployed units. Prevention of the leading causes of NBI should be a top priority for the Army.