The Epidemiology of Vascular Injury in the Wars in Iraq and Afghanistan

Blood vessel trauma leading to hemorrhage or ischemia presents a significant cause of morbidity and mortality after battlefield injury. The objective of this study is to characterize the epidemiology of vascular injury in the wars of Iraq and Afghanistan, including categorization of anatomic patterns, mechanism, and management of casualties. The Joint Theater Trauma Registry was interrogated (2002-2009) for vascular injury in US troops to identify specific injury (group 1) and operative intervention (group 2) groups. Battle-related injuries (nonreturn to duty) were used as the denominator to establish injury rates. Mechanism of injury was compared between theaters of war and the management strategies of ligation versus revascularization (repair and interposition grafting) reported. Group 1 included 1570 Troops injured in Iraq (OIF) (n = 1390) and Afghanistan (OEF) (n = 180). Mechanism included explosive (73%), gunshot (27%), and other (