34,006 personnel were medically evacuated, of whom 89% were men, 91% were enlisted, 82% were in the army, and 86% sustained an injury in Iraq. The most common reasons for medical evacuation were: musculoskeletal and connective tissue disorders (n=8104 service members, 24%), combat injuries (n=4713, 14%), neurological disorders (n=3502, 10%), psychiatric diagnoses (n=3108, 9%), and spinal pain (n=2445, 7%).
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Diagnoses and factors associated with medical evacuation and return to duty
Freedom or Operation Enduring Freedom: a prospective cohort study
By Dr Steven P Cohen MD, Charlie Brown MD, Connie Kurihara RN, Anthony Plunkett MD, Conner Nguyen MD, Scott A Strassels PhD.
SUMMARY
Background
Anticipation of the types of injuries that occur in modern warfare is essential to plan operations and maintain a healthy military. We aimed to identify the diagnoses that result in most medical evacuations, and ascertain which demographic and clinical variables were associated with return to duty.
Methods
Demographic and clinical data were prospectively obtained for US military personnel who had been medically evacuated from Operation Iraqi Freedom or Operation Enduring Freedom (January, 2004—December, 2007). Diagnoses were categorised post hoc according to the International Classification of Diseases codes that were recorded at the time of transfer. The primary outcome measure was return to duty within 2 weeks.
Findings
34 006 personnel were medically evacuated, of whom 89% were men, 91% were enlisted, 82% were in the army, and 86% sustained an injury in Iraq. The most common reasons for medical evacuation were: musculoskeletal and connective tissue disorders (n=8104 service members, 24%), combat injuries (n=4713, 14%), neurological disorders (n=3502, 10%), psychiatric diagnoses (n=3108, 9%), and spinal pain (n=2445, 7%). The factors most strongly associated with return to duty were being a senior officer (adjusted OR 2·01, 95% CI 1·71—2·35, p<0·0001), having a non-battle-related injury or disease (3·18, 2·77—3·67, p<0·0001), and presenting with chest or abdominal pain (2·48, 1·61—3·81, p<0·0001), a gastrointestinal disorder (non-surgical 2·32, 1·51—3·56, p=0·0001; surgical 2·62, 1·69—4·06, p<0·0001), or a genitourinary disorder (2·19, 1·43—3·36, p=0·0003). Covariates associated with a decreased probability of return to duty were serving in the navy or coast guard (0·59, 0·45—0·78, p=0·0002), or marines (0·86, 0·77—0·96, p=0·0083); and presenting with a combat injury (0·27, 0·17—0·44, p<0·0001), a psychiatric disorder (0·28, 0·18—0·43, p<0·0001), musculoskeletal or connective tissue disorder (0·46, 0·30—0·71, p=0·0004), spinal pain (0·41, 0·26—0·63, p=0·0001), or other wound (0·54, 0·34—0·84, p=0·0069).
Interpretation
Implementation of preventive measures for service members who are at highest risk of evacuation, forward-deployed treatment, and therapeutic interventions could reduce the effect of non-battle-related injuries and disease on military readiness.
Funding
John P Murtha Neuroscience and Pain Institute, and US Army Regional Anesthesia and Pain Management Initiative.
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Rev. Dr. Martin Luther King, Jr.
Excerpts of a Sermon at the Ebenezer Baptist Church on April 30, 1967.
You may not know it my friend, but it is estimated that we spend $500,000 dollars to kill each enemy soldier, while we spend only $53.00 dollars for each person classified as poor. And, most of that $53.00 dollars goes to salaries for people who are not poor.
The Western arrogance, of feeling that it has everything to teach others and, nothing to learn from them, is not just. A true revolution of values will lay hands on the World Order, and say of war…this way of settling differences…is not just.
A nation that continues, year after year, to spend more money on military defense (offence), than on programs of social uplift, is approaching spiritual death.
We are presently moving down a dead end road that can lead to national disaster.
All men (human beings) are made in the image of God…all men are brothers…all men are created equal.
Every man is an heir to a legacy of dignity, and worth. Every man has rights…that are neither conferred by, nor derived from, the STATE…they are God given.
Out of one blood…God made all men to dwell upon the face of the earth…what a marvelous foundation for any home…what a glorious and healthy place to inhabit…but we strayed away. And this un-natural excursion has brought only confusion, and bewilderment.
It has left hearts aching with guilt, and minds distorted with irrationality.
It is time for all people of conscious, to call upon America, to come back home…come home America.
We shall have to repent in this generation, not so much for the evil deeds of the wicked people, but for the appalling silence of the good people.
Rev. Dr. Martin Luther King, Jr. – 1929-1968.
The Link: http://www.youtube.com/watch?v=b80Bsw0UG-U
Man has no right to kill his brother. It is no excuse that he does so in uniform: he only adds the infamy of servitude, to the crime of murder.
Percy Bysshe Shelley (poet) – 1792-1822.