Aeromedical Evacuations from Operation Iraqi Freedom: A Descriptive Study

Military Medicine,  Jun 2005  by Harman, Dale R,  Hooper, Tomoko I,  Gackstetter, Gary D

• E-mail
• Print
• Link

Our efforts to construct a linked data set yielded pre- and postdeployment questionnaire information from DMSS for about two-thirds of the patients at the time of the data request, even thought the completion of this form is required for all deploying personnel. However, updates to the DMSS database are continuous, and this rich source of health information can enhance or validate other data sources, such as TRAC^sup 2^ES. In addition to pre- and postdeployment surveys, DMSS includes entrance and periodic physical examination data, service and deployment information, and vaccination history. From an epidemiological perspective, the ability to link TRAC^sup 2^ES and DMSS offers great potential for descriptive and analytic studies to aid in the development of targeted preventive measures to reduce future evacuations out of theater, to mitigate illness and injury complications, and to inform policy on postdeployment health care needs.

In-theater ICD-9-CM codes represent preliminary diagnoses at the time of aeromedical evacuation. Linking with medical encounter information from the DMSS will allow us to compare initial diagnoses with final hospital discharge diagnoses and to describe follow-up care, disability, and separation from military service in the postdeployment period. In addition, examination of predeployment ICD-9-CM codes for medical encounters may identify predisposing conditions or circumstances, not captured at the time of predeployment screening, that increase the risk of medical evacuation during deployment.

This study corroborates the AMSA report on TRAC^sup 2^ES as a valuable source of health data. This real-time data source can fulfill some medical surveillance needs as well as establish a dynamic cohort for contingency operations that can be studied for modifiable risk factors and short- and long-term health outcomes as part of the DoD's force health protection efforts. Future detailed subgroup analyses are planned and will include analyses of battle and DNBI injuries and ICD-9-CM codes by gender, occupation, service component, and time in theater. Results of our TRAC^sup 2^ES study will be combined with a systematic assessment of other data sources for in-theater medical events to complete the picture. These steps will ensure progress toward instituting and evaluating preventive measures to minimize morbidity, mortality, and disability, and to maximize quality of life among our fighting forces.

Acknowledgments

We thank Drs. Michael Kilpatrick, Ken Cox, and John Gardner from the Deployment Health Support Directorate, Office of the Assistant secretary of Defense, Health Affairs, the staff of the Army Medical Surveillance Activity, Ms Cara Olsen from the Department of Preventive Medicine and Biometrics, and Ms Kim Bellis from the Center for Force Health Protection Studies at the Uniformed Services University of the Health Sciences.

References

1. Thacker SB, Koplan JP, Taylor WR, et al: Assessing prevention effectiveness using data to drive program decisions. Public Health Rep 1994; 109: 187-94.