A descriptive study of US Special Operations Command fatalities, 2001 to 2018

Russ S. Kotwal, Edward L. Mazuchowski, Caryn A. Stern, Harold R. Montgomery, Jud C. Janak, Jeffrey T. Howard, Frank K. Butler, John B. Holcomb, Brian J Eastridge, Jennifer M. Gurney, Stacy A. Shackelford

Research output: Contribution to journalArticle

Abstract

BACKGROUND Studies of fatalities from injury and disease guide prevention and treatment efforts for populations at risk. Findings can inform leadership and direct clinical practice guidelines, research, and personnel, training, and equipment requirements. METHODS A retrospective review and descriptive analysis was conducted of United States Special Operations Command (USSOCOM) fatalities who died while performing duties from September 11, 2001, to September 10, 2018. Characteristics analyzed included subcommand, military activity, operational posture, and manner of death. RESULTS Of 614 USSOCOM fatalities (median age, 30 years; male, 98.5%) the leading cause of death was injury (97.7%); specifically, multiple/blunt force injury (34.5%), blast injury (30.7%), gunshot wound (GSW; 30.3%), and other (4.5%). Most died outside the United States (87.1%), during combat operations (85.3%), in the prehospital environment (91.5%), and the same day of insult (90.4%). Most fatalities were with the US Army Special Operations Command (67.6%), followed by the Naval Special Warfare Command (16.0%), Air Force Special Operations Command (9.3%), and Marine Corps Forces Special Operations Command (7.2%). Of 54.6% who died of injuries incurred during mounted operations, most were on ground vehicles (53.7%), followed by rotary-wing (37.3%) and fixed-wing (9.0%) aircrafts. The manner of death was primarily homicide (66.0%) and accident (30.5%), followed by natural (2.1%), suicide (0.8%), and undetermined (0.7%). Specific homicide causes of death were GSW (43.7%), blast injury (42.2%), multiple/blunt force injury (13.8%), and other (0.2%). Specific accident causes of death were multiple/blunt force injury (80.7%), blast injury (6.4%), GSW (0.5%), and other (12.3%). Of accident fatalities with multiple/blunt force injury, the mechanism was mostly aircraft mishaps (62.9%), particularly rotary wing (68.4%). CONCLUSION Most USSOCOM fatalities died abroad from injury in the prehospital setting. To improve survival from military activities worldwide, leaders must continue to optimize prehospital capability and develop strategies that rapidly connect patients to advanced resuscitative and surgical care. LEVEL OF EVIDENCE Epidemiological, level IV; Therapeutic level IV.

Original languageEnglish (US)
Pages (from-to)645-657
Number of pages13
JournalJournal of Trauma and Acute Care Surgery
Volume87
Issue number3
DOIs
StatePublished - Sep 1 2019

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Nonpenetrating Wounds
Blast Injuries
Accidents
Cause of Death
Aircraft
Homicide
Wounds and Injuries
Gunshot Wounds
Military Personnel
Posture
Practice Guidelines
Suicide
Air
Research Personnel
Equipment and Supplies
Survival
Therapeutics

Keywords

  • Cause of death
  • manner of death
  • military
  • special operations forces

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Kotwal, R. S., Mazuchowski, E. L., Stern, C. A., Montgomery, H. R., Janak, J. C., Howard, J. T., ... Shackelford, S. A. (2019). A descriptive study of US Special Operations Command fatalities, 2001 to 2018. Journal of Trauma and Acute Care Surgery, 87(3), 645-657. https://doi.org/10.1097/TA.0000000000002354

A descriptive study of US Special Operations Command fatalities, 2001 to 2018. / Kotwal, Russ S.; Mazuchowski, Edward L.; Stern, Caryn A.; Montgomery, Harold R.; Janak, Jud C.; Howard, Jeffrey T.; Butler, Frank K.; Holcomb, John B.; Eastridge, Brian J; Gurney, Jennifer M.; Shackelford, Stacy A.

In: Journal of Trauma and Acute Care Surgery, Vol. 87, No. 3, 01.09.2019, p. 645-657.

Research output: Contribution to journalArticle

Kotwal, RS, Mazuchowski, EL, Stern, CA, Montgomery, HR, Janak, JC, Howard, JT, Butler, FK, Holcomb, JB, Eastridge, BJ, Gurney, JM & Shackelford, SA 2019, 'A descriptive study of US Special Operations Command fatalities, 2001 to 2018', Journal of Trauma and Acute Care Surgery, vol. 87, no. 3, pp. 645-657. https://doi.org/10.1097/TA.0000000000002354
Kotwal RS, Mazuchowski EL, Stern CA, Montgomery HR, Janak JC, Howard JT et al. A descriptive study of US Special Operations Command fatalities, 2001 to 2018. Journal of Trauma and Acute Care Surgery. 2019 Sep 1;87(3):645-657. https://doi.org/10.1097/TA.0000000000002354
Kotwal, Russ S. ; Mazuchowski, Edward L. ; Stern, Caryn A. ; Montgomery, Harold R. ; Janak, Jud C. ; Howard, Jeffrey T. ; Butler, Frank K. ; Holcomb, John B. ; Eastridge, Brian J ; Gurney, Jennifer M. ; Shackelford, Stacy A. / A descriptive study of US Special Operations Command fatalities, 2001 to 2018. In: Journal of Trauma and Acute Care Surgery. 2019 ; Vol. 87, No. 3. pp. 645-657.
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abstract = "BACKGROUND Studies of fatalities from injury and disease guide prevention and treatment efforts for populations at risk. Findings can inform leadership and direct clinical practice guidelines, research, and personnel, training, and equipment requirements. METHODS A retrospective review and descriptive analysis was conducted of United States Special Operations Command (USSOCOM) fatalities who died while performing duties from September 11, 2001, to September 10, 2018. Characteristics analyzed included subcommand, military activity, operational posture, and manner of death. RESULTS Of 614 USSOCOM fatalities (median age, 30 years; male, 98.5{\%}) the leading cause of death was injury (97.7{\%}); specifically, multiple/blunt force injury (34.5{\%}), blast injury (30.7{\%}), gunshot wound (GSW; 30.3{\%}), and other (4.5{\%}). Most died outside the United States (87.1{\%}), during combat operations (85.3{\%}), in the prehospital environment (91.5{\%}), and the same day of insult (90.4{\%}). Most fatalities were with the US Army Special Operations Command (67.6{\%}), followed by the Naval Special Warfare Command (16.0{\%}), Air Force Special Operations Command (9.3{\%}), and Marine Corps Forces Special Operations Command (7.2{\%}). Of 54.6{\%} who died of injuries incurred during mounted operations, most were on ground vehicles (53.7{\%}), followed by rotary-wing (37.3{\%}) and fixed-wing (9.0{\%}) aircrafts. The manner of death was primarily homicide (66.0{\%}) and accident (30.5{\%}), followed by natural (2.1{\%}), suicide (0.8{\%}), and undetermined (0.7{\%}). Specific homicide causes of death were GSW (43.7{\%}), blast injury (42.2{\%}), multiple/blunt force injury (13.8{\%}), and other (0.2{\%}). Specific accident causes of death were multiple/blunt force injury (80.7{\%}), blast injury (6.4{\%}), GSW (0.5{\%}), and other (12.3{\%}). Of accident fatalities with multiple/blunt force injury, the mechanism was mostly aircraft mishaps (62.9{\%}), particularly rotary wing (68.4{\%}). CONCLUSION Most USSOCOM fatalities died abroad from injury in the prehospital setting. To improve survival from military activities worldwide, leaders must continue to optimize prehospital capability and develop strategies that rapidly connect patients to advanced resuscitative and surgical care. LEVEL OF EVIDENCE Epidemiological, level IV; Therapeutic level IV.",
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T1 - A descriptive study of US Special Operations Command fatalities, 2001 to 2018

AU - Kotwal, Russ S.

AU - Mazuchowski, Edward L.

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AU - Montgomery, Harold R.

AU - Janak, Jud C.

AU - Howard, Jeffrey T.

AU - Butler, Frank K.

AU - Holcomb, John B.

AU - Eastridge, Brian J

AU - Gurney, Jennifer M.

AU - Shackelford, Stacy A.

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N2 - BACKGROUND Studies of fatalities from injury and disease guide prevention and treatment efforts for populations at risk. Findings can inform leadership and direct clinical practice guidelines, research, and personnel, training, and equipment requirements. METHODS A retrospective review and descriptive analysis was conducted of United States Special Operations Command (USSOCOM) fatalities who died while performing duties from September 11, 2001, to September 10, 2018. Characteristics analyzed included subcommand, military activity, operational posture, and manner of death. RESULTS Of 614 USSOCOM fatalities (median age, 30 years; male, 98.5%) the leading cause of death was injury (97.7%); specifically, multiple/blunt force injury (34.5%), blast injury (30.7%), gunshot wound (GSW; 30.3%), and other (4.5%). Most died outside the United States (87.1%), during combat operations (85.3%), in the prehospital environment (91.5%), and the same day of insult (90.4%). Most fatalities were with the US Army Special Operations Command (67.6%), followed by the Naval Special Warfare Command (16.0%), Air Force Special Operations Command (9.3%), and Marine Corps Forces Special Operations Command (7.2%). Of 54.6% who died of injuries incurred during mounted operations, most were on ground vehicles (53.7%), followed by rotary-wing (37.3%) and fixed-wing (9.0%) aircrafts. The manner of death was primarily homicide (66.0%) and accident (30.5%), followed by natural (2.1%), suicide (0.8%), and undetermined (0.7%). Specific homicide causes of death were GSW (43.7%), blast injury (42.2%), multiple/blunt force injury (13.8%), and other (0.2%). Specific accident causes of death were multiple/blunt force injury (80.7%), blast injury (6.4%), GSW (0.5%), and other (12.3%). Of accident fatalities with multiple/blunt force injury, the mechanism was mostly aircraft mishaps (62.9%), particularly rotary wing (68.4%). CONCLUSION Most USSOCOM fatalities died abroad from injury in the prehospital setting. To improve survival from military activities worldwide, leaders must continue to optimize prehospital capability and develop strategies that rapidly connect patients to advanced resuscitative and surgical care. LEVEL OF EVIDENCE Epidemiological, level IV; Therapeutic level IV.

AB - BACKGROUND Studies of fatalities from injury and disease guide prevention and treatment efforts for populations at risk. Findings can inform leadership and direct clinical practice guidelines, research, and personnel, training, and equipment requirements. METHODS A retrospective review and descriptive analysis was conducted of United States Special Operations Command (USSOCOM) fatalities who died while performing duties from September 11, 2001, to September 10, 2018. Characteristics analyzed included subcommand, military activity, operational posture, and manner of death. RESULTS Of 614 USSOCOM fatalities (median age, 30 years; male, 98.5%) the leading cause of death was injury (97.7%); specifically, multiple/blunt force injury (34.5%), blast injury (30.7%), gunshot wound (GSW; 30.3%), and other (4.5%). Most died outside the United States (87.1%), during combat operations (85.3%), in the prehospital environment (91.5%), and the same day of insult (90.4%). Most fatalities were with the US Army Special Operations Command (67.6%), followed by the Naval Special Warfare Command (16.0%), Air Force Special Operations Command (9.3%), and Marine Corps Forces Special Operations Command (7.2%). Of 54.6% who died of injuries incurred during mounted operations, most were on ground vehicles (53.7%), followed by rotary-wing (37.3%) and fixed-wing (9.0%) aircrafts. The manner of death was primarily homicide (66.0%) and accident (30.5%), followed by natural (2.1%), suicide (0.8%), and undetermined (0.7%). Specific homicide causes of death were GSW (43.7%), blast injury (42.2%), multiple/blunt force injury (13.8%), and other (0.2%). Specific accident causes of death were multiple/blunt force injury (80.7%), blast injury (6.4%), GSW (0.5%), and other (12.3%). Of accident fatalities with multiple/blunt force injury, the mechanism was mostly aircraft mishaps (62.9%), particularly rotary wing (68.4%). CONCLUSION Most USSOCOM fatalities died abroad from injury in the prehospital setting. To improve survival from military activities worldwide, leaders must continue to optimize prehospital capability and develop strategies that rapidly connect patients to advanced resuscitative and surgical care. LEVEL OF EVIDENCE Epidemiological, level IV; Therapeutic level IV.

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KW - manner of death

KW - military

KW - special operations forces

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