Mortality epidemiology in low-intensity warfare: Israel Defense Forces' experience

Purpose: an analysis of the mortality epidemiology in low-intensity warfare. Basic procedures: we retrospectively reviewed all cases of Israeli soldiers killed in small-scale warfare during 1996-1998, using field data, hospital charts and autopsy reports. Data on injury pattern, offending munitions and time of death were analyzed. Main findings: in the study period, 106 soldiers were killed. Penetrating trauma was the common injury mechanism (95%) most frequently due to claymore bombs and gunshot bullets. The percentage dying in the prehospital phase and in the first 30-min were 77 and 88%, respectively. The average injury severity score (ISS) was 42.5. Seriously injured body regions were thorax (38%), head (24%), abdomen and pelvis (13%) and neck (12%). Conclusions: there is no trimodal death distribution in military trauma. Most casualties of low-scale conflicts die very early after injury. Most fatal injuries involve the head and trunk regions. The distribution of injury depends on the type of assaulting munitions. (C) 2001 Elsevier Science Ltd. All rights reserved.