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Industry: Email Alert RSS FeedAeromedical Evacuations from Operation Iraqi Freedom: A Descriptive Study
Military Medicine, Jun 2005 by Harman, Dale R, Hooper, Tomoko I, Gackstetter, Gary D
The total number of lines of data from TRAC^sup 2^ES for aeromedical evacuations from OIF, originating in CENTCOM in the calendar year 2003, was 28,404. Each line containing an invalid or incomplete social security number was excluded (n = 476). Because each leg of an aeromedical evacuation is entered into TRAC^sup 2^ES as a new line of data, in many cases there are multiple lines of data for an individual patient. Thus, all but the first record per patient was excluded (n = 11,650), when more than one flight was required to reach the desired destination. Each duplicate record was carefully reviewed to ensure that it was temporally linked to the first record and not a separate evacuation because of a second injury or illness. This left 16,278 remaining records.
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After invalid or duplicate social security numbers had been excluded, AMSA linked these data from TRAC^sup 2^ES (n = 16,278) with DMSS data elements, including ICD-9-CM diagnostic codes from pre- and postdeployment inpatient and outpatient encounters and selected portions of the most current pre- and postdeployment health surveys. Once data linking was completed and before analysis, individual identifying information was removed to protect patient confidentiality. A large number of individuals (n = 4,534) in the linked data set were identified as deployed in support of Operation Enduring Freedom or were not specifically designated as OIF participants in the appropriate data field. To validate deployment information, we scanned alternate data fields and identified an additional 88 OIF deployed personnel. Data pertaining to patients not deployed to OIF (n = 4,446), as well as all nonmilitary personnel (n = 649), were subsequently excluded. The remaining 11,183 cases constituted our final analytic data set. Figure 2 illustrates this process.
For purposes of this initial assessment of OIF illnesses and injuries, we examined demographic information, ICD-9-CM diagnostic codes, and other health-related information from TRAC2ES to characterize aeromedical evacuations. Our linked data set, containing pre- and postdeployment survey information, as well as pre- and postdeployment inpatient and outpatient encounter data, will be used in future analyses. Descriptive statistics were generated using SPSS 11.5 for Windows (SPSS Inc., Chicago, Illinois) and Microsoft Excel 2000 (Microsoft Corporation, Redmond, Washington).
Our protocol was reviewed and approved by the Institutional Review Board at the Uniformed Services University of the Health Sciences.
Results
The demographic distribution of aeromedically evacuated military personnel is shown in Table I. The Army comprised the majority of patients (85.5%), with the Marines, Air Force, and Navy constituting nearly all of the remaining patients (14.4%). Most evacuees were male (81.4%) and nearly one-third (31.9%) were between the ages of 20 and 24 years old. The proportion of evacuees in older age categories steadily decreased.
Table II illustrates the number of aeromedical evacuations by quarter during the calendar year 2003. Most (40%) occurred during the second quarter and the least (9.7%) during the first quarter. The numbers declined in the third (34%) and fourth (16.3%) quarters. The most common reason for evacuation was DNBI (86.5%). The remainder (13.5%) was for injuries directly related to combat. Only a few evacuations were classified as urgent (1.4%), i.e., requiring transport immediately to save life or limb or to help prevent serious complications. Slightly more were classified as priority evacuations (4.6%), requiring transport within 24 hours with minimal delay en route. The vast majority of evacuations were classified as routine (94%), indicating that evacuation could safely take place within 72 hours.
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