{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T20:47:35Z","timestamp":1740170855568,"version":"3.37.3"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"11-12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The U.S. Army Aeromedical Research Laboratory (USAARL), a partner in the Joint Trauma Analysis for the Prevention of Injury in Combat (JTAPIC) partnership, conducted a series of retrospective reviews to investigate injuries sustained by occupants of U.S. Army rotary-wing aircraft involved in combat damage incidents. The reviews were conducted to provide occupant survivability information to the Aviation Survivability Development and Tactics team, an agency within the U.S. Army Aviation Center of Excellence. For these reviews, combat damage incidents that produced casualties were separated into direct events (i.e., events in which an enemy weapon system directly injured occupants) and indirect events (i.e., incidents in which occupants were injured as a result of a crash caused by the enemy weapon system). The previous USAARL reviews provided an overview of injuries sustained during direct and indirect events. The objective of this review was to conduct a detailed analysis of injuries occurring during direct events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A descriptive retrospective review was conducted on injuries sustained by occupants of U.S. Army rotary-wing aircraft involved in combat damage incidents between 2003 and 2014. All Black Hawk, Apache, and Chinook combat aviation damage incidents for the study period were reviewed. Personnel casualty information from the Defense Casualty Information Processing System (DCIPS) was linked to combat damage incident information by matching the aircraft platform, incident date, and circumstantial information found in incident narratives. Injury information for personnel identified in DCIPS as being wounded in action was obtained from the JTAPIC partnership; injury data for personnel killed in action were retrieved from the Armed Forces Medical Examiner System. All injuries were coded using the Abbreviated Injury Scale (AIS). Descriptive statistics were used to describe the frequency and distribution of injuries to personnel involved in direct events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, the extremities were the most commonly injured body regions, with lower extremities suffering more injuries than upper extremities. Penetrating injuries were identified as the primary injury mechanism for all body regions. Injuries to each AIS body region were predominantly of minor (AIS 1) and moderate (AIS 2) severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although injury severities were generally low (AIS 1 or AIS 2), the results of this effort indicate which body regions may benefit from additional protection during rotary-wing operations in hostile environments. The influence of occupant position within the aircraft and the use and effectiveness of personal protective equipment could not be effectively analyzed due to a lack of information.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae301","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T21:37:54Z","timestamp":1718228274000},"page":"e2475-e2481","source":"Crossref","is-referenced-by-count":0,"title":["Direct Combat-related U.S. Army Aviation Injuries 2003\u20132014"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3954-2707","authenticated-orcid":false,"given":"Frederick T","family":"Brozoski","sequence":"first","affiliation":[{"name":"U.S. Army Aeromedical Research Laboratory , Fort Novosel, AL 36362,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcy","family":"Conti","sequence":"additional","affiliation":[{"name":"U.S. Army Aeromedical Research Laboratory , Fort Novosel, AL 36362,","place":["USA"]},{"name":"Katmai Government Solutions, LLC , Anchorage, AK 99515,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Dudek","sequence":"additional","affiliation":[{"name":"U.S. Army Aeromedical Research Laboratory , Fort Novosel, AL 36362,","place":["USA"]},{"name":"Katmai Government Solutions, LLC , Anchorage, AK 99515,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeta Carol","family":"Chancey","sequence":"additional","affiliation":[{"name":"U.S. Army Aeromedical Research Laboratory , Fort Novosel, AL 36362,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S","family":"Crowley","sequence":"additional","affiliation":[{"name":"U.S. Army Aeromedical Research Laboratory , Fort Novosel, AL 36362,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"volume-title":"A History of Army Aviation: From Its Beginnings to the War on Terror","year":"2005","author":"Williams","key":"2024110620105911200_R1"},{"key":"2024110620105911200_R2","first-page":"2434","article-title":"Study on rotorcraft safety and survivability","volume":"66","author":"Couch","year":"2010","journal-title":"Proc Am Helicopter Soc"},{"issue":"4","key":"2024110620105911200_R3","doi-asserted-by":"publisher","first-page":"220","DOI":"10.7205\/MILMED-D-09-00130","article-title":"Death and injury rates of U.S. military personnel in Iraq","volume":"175","author":"Goldberg","year":"2010","journal-title":"Mil Med"},{"issue":"1","key":"2024110620105911200_R4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/TA.0b013e318250bfb4","article-title":"Combat wounds in Iraq and Afghanistan from 2005 to 2009","volume":"73","author":"Belmont","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2024110620105911200_R5","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-50272-3","article-title":"Patterns of anatomic injury in critically injured combat casualties: A network analysis","volume":"9","author":"Janak","year":"2019","journal-title":"Sci Rep"},{"volume-title":"Vietnam Studies: Medical Support 1965-1970","year":"1973","author":"Neel","key":"2024110620105911200_R6"},{"key":"2024110620105911200_R7","article-title":"U.S. Army Casualties Aboard Aircraft in the Republic of Vietnam (1962 through 1967)","volume-title":"Memorandum Report No. 2030","author":"Bernier","year":"1970"},{"volume-title":"Military Specification:Visors, Flyer\u2019s Helmet, Polycarbonate","year":"1990","author":"Department of Defense","key":"2024110620105911200_R8"},{"key":"2024110620105911200_R9","article-title":"Aviation Survivability Development And Tactics (ASDAT) Combat-Related Injury Retrospective Study, Stage Black Hawk, 2003-2014, Volume I","volume-title":"Technical Report USAARL-TR-2018-01a","author":"Dudek","year":"2018"},{"key":"2024110620105911200_R10","article-title":"Aviation Survivability Development And Tactics (ASDAT) Combat-Related Injury Retrospective Study, Stage Apache, 2003-2014, Volume I","volume-title":"Technical Report USAARL-TR-2020-18a","author":"Dudek","year":"2020"},{"key":"2024110620105911200_R11","article-title":"Recommendations for Protection of Future Vertical Lift Crew and Passengers from Enemy Action in Combat \u2014 Black Hawk and Apache","volume-title":"Technical Report USAARL-TECH-SR\u20142021-31","author":"McEntire","year":"2021"},{"volume-title":"AIS 2005-Update 2008","year":"2008","author":"Gennarelli","key":"2024110620105911200_R12"},{"author":"Blast Injury Research Coordinating Office (BIRCO)","key":"2024110620105911200_R13","article-title":"What is blast injury? 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