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June 21, 2004 — Military neurosurgeons
serving in Operation Iraqi Freedom have
recently reported a significant decrease
in casualty rates compared with other recent
conflicts. The study, "The Neurosurgical
Experience at an Echelon 5 Facility During
Operation Iraqi Freedom was presented during
the 72nd Annual Meeting of the American
Association of Neurological Surgeons in
Orlando, Florida. Authors of the study
include Jonathan E. Martin, MD; Randy Bell,
MD; William T. Monacci, MD; Ross R. Moquin,
MD; James M. Ecklund, MD, and Geoff S.
Ling, MD.
Operation Iraqi Freedom is the largest
mobilization of American military forces
in the past decade. The authors review
the clinical experience of a neurosurgical
service providing care to personnel evacuated
to the primary stateside United States
Army medical facility during the military
phase of the operation.
To review and evaluate the neurosurgical
service, the authors consulted with all
aeromedical evacuees to Walter Reed Army
Medical Center from March 15 to May 15,
2003. All completed consults were then
categorized based on the type of illness
and injury, evacuation time from the point
of injury, and location of the performed
intervention.
The results of the review indicate that
a total of 56 patients were admitted to,
or received consultation from, the neurosurgical
service during this time period. The patients
within this group included those with closed-
and penetrating head injuries, and spine
and peripheral nerve injuries, in addition
to noncombatant neurosurgical disease.
Patients had received neurosurgical care
at one of a number of facilities including
combat support hospitals, hospital ships,
host nation facilities and stateside medical
centers. The penetrating head and spine
injuries discovered were limited to regions
not covered by antiballistic helmets and/or
body armor.
"Our study of medical evacuees found
a substantial decrease in the overall casualty
rate, compared to other recent military
conflicts," said William T. Monacci,
MD. "We believe that renewed and updated
technical and tactical battlefield techniques
as well as advances in protective wear
seemed to reduce the number of wounded
soldiers."
Authors concluded that the medical center
had a critical role in the ongoing management
of severely injured casualties.
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