TY  - JOUR
PY  - 2018//
TI  - An analysis of injuries and prehospital interventions sustained by females in the Iraq and Afghanistan combat zones
JO  - Prehospital emergency care
A1  - Schauer, Steven G.
A1  - Naylor, Jason F.
A1  - Long, Adrianna
A1  - Mora, Alejandra
A1  - Le, Tuan D.
A1  - Maddry, Joseph K.
A1  - April, Michael D.
SP  - 1
EP  - 8
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Women served in both combat and non-combat units in the recent conflicts in Iraq and Afghanistan. Moreover, the recent conflicts lacked traditional separation of civilians from combatants carrying additional risk for injury to local civilians. There is a relative paucity of data specific to this topic. We compare injury patterns and interventions performed in the prehospital, combat setting among females versus males. <br><br>METHODS: This is a secondary analysis of previously published data from the Department of Defense Trauma Registry. We included all subjects that had at least one prehospital intervention documented. We compared variables between females and males. <br><br>RESULTS: From January 2007 to August 2016, our inclusion criteria captured 19485 males and 533 females. Female casualties were older (median age 29 versus 25), less likely to have sustained injuries from explosives (48.0% versus 56.8%), and more severely injured as measured by median composite injury scores (10 versus 9). Most subjects were in Afghanistan for both females and males (52.9% versus 73.9%). Among United States (US) service members, findings were similar to the overall study population, except female service members had lower median composite injury scores than males (5 vs 9). In unadjusted analyses, females were less likely to survive to hospital discharge (OR 0.68, 95% CI 0.48-0.97). When controlling for confounders, there was no difference in survival (OR 0.73, 95% CI 0.50-1.07). In both unadjusted and adjusted analyses specific to US forces, we were unable to detect any differences in survival or for select analgesic administration. In both unadjusted and adjusted analyses specific to host nation civilians, we were unable to detect any differences in survival, however, even when controlling for confounders females were less likely to receive ketamine and IV morphine (OR 0.31, 95% CI 0.15-0.63; 0.69, 95% CI 0.49-0.98, respectively). <br><br>CONCLUSIONS: Females accounted for a small proportion of total casualties within our dataset. After controlling for confounders, survival was comparable between males and females, but host nation females were less likely to receive ketamine and intravenous morphine. Future studies should seek to elucidate the reasons for these subtle differences between males and females in prehospital combat casualty care.<p />  <p>Language: en</p>
LA  - en
SN  - 1090-3127
UR  - http://dx.doi.org/10.1080/10903127.2018.1560849
ID  - ref1
ER  -