Coding of the WDMET Database

An essential prerequisite in preparing for war or other military combat is an understanding of the risks, nature, and severity of likely injuries and of the medical resources required to treat them. Without a clear understanding of these elements, a mismatch of resources can result in the threat to life or limb, inappropriate logistic burden, and mission failure. Comparison of contemporary data with data from previous conflicts is essential. Prior to this effort the last combat database developed by the U.S. military of any significance is the Wound Data and Munitions Effectiveness Team (WDMET) database acquired in 1965-67 in Vietnam and representing less than 4% (N=7,989) of those injured or killed in that conflict. This database was not in a functional electronic format. The injury information had not been coded into useable injury taxonomies (ICD-9-CM and ICD-10-CM) and severity scales (AIS) for comparison with other databases. However, despite its many shortcomings, it formed the basis of much strategic tactical and logistic thinking in military medicine despite radical changes in armor, tactical settings, and combat doctrine. U.S. conflicts since that time had resulted in small casualty numbers with little injury data for nonsurvivors as few complete autopsies were performed. Furthermore, casualty estimates, and consequently medical resources are currently often based on models created by individuals without combat knowledge or insight and modulated by assumptions and theories that could not be evaluated. This project has coded some 7,898 patient injuries that are recorded in the WDMET into contemporary injury severity taxonomies, including injury severity scoring. The result is that the WDMET database can now be used to perform comparative or aggregate analyses with both civilian trauma registry data and contemporary combat data being acquired from the contemporary conflicts in Iraq and Afghanistan.