Analysis of the causes of death of casualties in field military setting

Objective: We assessed the causes of death of military casualties in order to determine the characteristics of injury and to determine how survivability can be improved. Methods: A retrospective review of the trauma registry of the Israel Defense Forces was conducted. The causes of death were determined. Casualties that were found alive but died later at any level of care were included. Results: Information about casualties that was recorded during the years 2002-2009 was reviewed. Eighty-one fatalities were included in the analysis. Fifty-one (63%) fatalities were caused by gunshot wounds. Analysis of the data regarding the cause of death revealed that 66 (81.5%) of the casualties died because of hemorrhage and 25 (30.9%) because of head trauma. Of the casualties that died of hemorrhage, 12 (18.2%) had neck or limbs potentially compressible hemorrhage. All fatalities from hemorrhage died before arriving at a medical facility. Conclusion: Torso noncompressible hemorrhage was found to be the main cause of death among the casualties investigated. Potentially compressible hemorrhage and head injury are significant too. Research and development of means to treat hemorrhage and emphasis on distribution of means to stop hemorrhage and on training may improve outcome of potentially compressible hemorrhage.