{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:56Z","timestamp":1792786016852,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","funder":[{"name":"U.S. Navy Bureau of Medicine","award":["60808"],"award-info":[{"award-number":["60808"]}],"id":[{"id":"https:\/\/ror.org\/03cs53d16","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The proliferation of drone warfare is a significant threat to U.S. forces. Research on drone-related injuries is critically needed to prepare military healthcare providers for combat casualty care. The study objective was to assess wounding patterns among U.S. service members injured in drone attacks during deployment in the Central Command area of operations in 2023-2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Service members with drone-related injuries were identified in the Expeditionary Medical Encounter Database. Injuries were assessed using International Classification of Diseases, 10th Revision, Clinical Modification and Abbreviated Injury Scale (AIS) codes. Service members were grouped by their maximum AIS score in any body region as minor (MAIS 1), moderate (MAIS 2), or serious injury (MAIS 3+). Differences between groups were assessed by AIS body region. This study was approved by the Naval Health Research Center Institutional Review Board.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 367 service members were wounded in drone attacks during the study period. Approximately 48.5% had a traumatic brain injury. Of 710 injuries identified, most were minor (92.3%) and primarily involved the head and neck region (81.0%), followed by extremities (13.5%). Most injuries with moderate or higher severity (n\u2009=\u200953) were to the head (43.4%), thorax (18.9%), and upper extremities (15.1%). Those in the moderate (MAIS 2) compared with minor (MAIS 1) injury group had significantly higher proportions of thorax (45.8% vs. 1.5%) and spine injuries (20.8% vs. 4.2%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>U.S. forces injured during drone attacks most frequently sustained head injuries, marking a significant shift in wounding patterns from previous conflicts characterized by lower extremity trauma. Results suggest a dual preparedness strategy is needed for combat casualty care to manage a high volume of minor head injuries while retaining advanced surgical capabilities for less frequent but serious head and upper body trauma. Further research on wounding patterns and a re-evaluation of personal protective equipment are essential as drone warfare continues to evolve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag466","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T12:30:46Z","timestamp":1790425846000},"source":"Crossref","is-referenced-by-count":0,"title":["Drone-Related Injuries Among Deployed U.S. Military Personnel, 2023-2024"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2933-5675","authenticated-orcid":false,"given":"Jessamyn E","family":"Boltz","sequence":"first","affiliation":[{"name":"Epidemiology and Data Management Support Department, Naval Health Research Center , San Diego, CA 92106,","place":["United States"]},{"name":"Leidos, Inc. , San Diego, CA 92121,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber L","family":"Dougherty","sequence":"additional","affiliation":[{"name":"Epidemiology and Data Management Support Department, Naval Health Research Center , San Diego, CA 92106,","place":["United States"]},{"name":"Leidos, Inc. , San Diego, CA 92121,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Naval Medical Center San Diego , San Diego, CA 92134,","place":["United States"]},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6822-9803","authenticated-orcid":false,"given":"Brian E","family":"Wilson","sequence":"additional","affiliation":[{"name":"Epidemiology and Data Management Support Department, Naval Health Research Center , San Diego, CA 92106,","place":["United States"]},{"name":"Axiom Resource Management, Inc. , Falls Church, VA 22042,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M","family":"Zouris","sequence":"additional","affiliation":[{"name":"Epidemiology and Data Management Support Department, Naval Health Research Center , San Diego, CA 92106,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-1537","authenticated-orcid":false,"given":"Ryan W","family":"Smith","sequence":"additional","affiliation":[{"name":"Operational Readiness Directorate, Naval Health Research Center , San Diego, CA 92106,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"MacGregor","sequence":"additional","affiliation":[{"name":"Epidemiology and Data Management Support Department, Naval Health Research Center , San Diego, CA 92106,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"2026101612413264900_usag466-B1","doi-asserted-by":"publisher","first-page":"S180","DOI":"10.1097\/TA.0000000000004063","article-title":"Casualty care implications of large-scale combat operations","volume":"95","author":"Remondelli","year":"2023","journal-title":"J Trauma Acute Care Surg"},{"key":"2026101612413264900_usag466-B2","volume-title":"Improvised Explosive Devices (Ieds) in Iraq and Afghanistan: Effects and Countermeasures","author":"Wilson","year":"2007"},{"key":"2026101612413264900_usag466-B3","doi-asserted-by":"publisher","DOI":"10.1515\/9783110742039","volume-title":"De Gruyter Handbook of Drone Warfare","author":"Rogers","year":"2024"},{"key":"2026101612413264900_usag466-B4","article-title":"Weaponizing unmanned aircraft systems (UAS)","author":"Kneen","year":"2020","journal-title":"Defense Systems Information Analysis Center"},{"key":"2026101612413264900_usag466-B5","author":"Shertz","year":"2024"},{"key":"2026101612413264900_usag466-B6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12963-025-00373-1","article-title":"Civilian death and injury from airstrikes: evidence from the war in Tigray, Ethiopia","volume":"23","author":"Gebregziabher","year":"2025","journal-title":"Popul Health Metr"},{"key":"2026101612413264900_usag466-B7","first-page":"31","article-title":"Drones in the Nagorno-Karabakh war: analyzing the data","volume":"7","author":"Hechl","year":"2022","journal-title":"Mil Strategy Mag"},{"key":"2026101612413264900_usag466-B8","doi-asserted-by":"publisher","first-page":"e40","DOI":"10.1016\/S2542-5196(18)30265-1","article-title":"Traumatic amputations caused by drone attacks in the local population in Gaza: a retrospective cross-sectional study","volume":"3","author":"Heszlein-Lossius","year":"2019","journal-title":"Lancet Planet Health"},{"key":"2026101612413264900_usag466-B9","author":"US and coalition defeat Houthi attack in Red Sea area","year":"2024"},{"key":"2026101612413264900_usag466-B10","author":"USCENTCOM forces continue to target Houthi terrorists","year":"2025"},{"key":"2026101612413264900_usag466-B11","author":"U.S. forces launch Operation Epic Fury","year":"2026"},{"key":"2026101612413264900_usag466-B12","author":"US military casualties - Operation Epic Fury (OEFU) casualty summary by casualty category","year":"2026"},{"key":"2026101612413264900_usag466-B13","article-title":"National Center for Health Statistics. International classification of diseases,","year":"1980","journal-title":"ninth revision, clinical modification (ICD-9-CM)"},{"key":"2026101612413264900_usag466-B14","author":"World Health Organization","year":"2019"},{"key":"2026101612413264900_usag466-B15","author":"Association for the Advancement of Automotive Medicine","year":"2015"},{"key":"2026101612413264900_usag466-B16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00005373-197403000-00001","article-title":"The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care","volume":"14","author":"Baker","year":"1974","journal-title":"J Trauma"},{"key":"2026101612413264900_usag466-B17","first-page":"1","article-title":"The 2020 International Classification of Diseases, 10th revision, Clinical Modification Injury Diagnosis Framework for categorizing injuries by body region and nature of injury","author":"Hedegaard","year":"2020","journal-title":"Natl Health Stat Report"},{"key":"2026101612413264900_usag466-B18","volume-title":"A Review of US Military Traumatic Brain Injury Studies","author":"Hoch","year":"2025"},{"key":"2026101612413264900_usag466-B19","doi-asserted-by":"publisher","first-page":"1678","DOI":"10.1016\/j.injury.2012.05.027","article-title":"Injuries from combat explosions in Iraq: injury type, location, and severity","volume":"43","author":"Eskridge","year":"2012","journal-title":"Injury"},{"key":"2026101612413264900_usag466-B20","first-page":"45","volume-title":"Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects","author":"Cernak","year":"2015"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag466\/72048798\/usag466.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag466\/72048798\/usag466.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:41:41Z","timestamp":1792168901000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag466\/8931665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":20,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag466","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"article-number":"usag466"}}