Long-Term Outcomes of Thoracic Trauma in U.S. Service Members Involved in Combat Operations

ABSTRACT Introduction Nearly 10% of all combat injuries during the most recent conflicts in Iraq and Afghanistan involve thoracic trauma. The long-term outcomes of these combat-related injuries with respect to lung function have not been fully evaluated. Limited research in civilian polytrauma patie...

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Bibliographic Details
Published in:Military medicine 2020-12, Vol.185 (11-12), p.e2131-e2136
Main Authors: Hughes, Stephen M, Borders, Charles W, Aden, James K, Sjulin, Tyson J, Morris, Michael J
Format: Article
Language:English
Subjects:
Afghan Campaign 2001
Afghanistan
Humans
Injuries
Iraq
Iraq War, 2003-2011
Military Personnel
Physiology
Registries
Retrospective Studies
Thoracic Injuries - epidemiology
Trauma
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Summary:ABSTRACT Introduction Nearly 10% of all combat injuries during the most recent conflicts in Iraq and Afghanistan involve thoracic trauma. The long-term outcomes of these combat-related injuries with respect to lung function have not been fully evaluated. Limited research in civilian polytrauma patients have shown significant obstructive physiology in nearly half of their population without clear etiology. We sought to further characterize the extent to which these active duty service members (ADSM) are chronically affected by their thoracic injuries. Materials and Methods We conducted a retrospective chart review and analysis of ADSM who sustained thoracic injuries while deployed in support combat operations from 2003 to 2013. Using the Department of Defense Trauma Registry, 2,049 patients were found to have sustained thoracic trauma during these conflicts, of which we were able to identify 298 patients with postinjury pulmonary function testing (PFT) available for analysis. Following standardization of these tests using the established reference values, PFT was compared to a representative population of ADSM. Additional analysis was completed to detect incidence of abnormal PFTs when compared to both type of injury (burn, blunt, penetrating, and other) and also Injury Severity Score. Results In our patient population, there was a significant increase in abnormal PFTs when compared to a representative population. Of these, 31.8% of patients displayed obstructive physiology versus 3.7% in the control (P 
ISSN:0026-4075
1930-613X
DOI:10.1093/milmed/usaa165