U.S. military has improved mortality since World War II, with some alarming exceptions

New analysis shows that while the survivability of wounds on the battlefield has steadily improved for United States service members since World War II, there were several increases that bucked that trend during subsequent conflicts. By understanding these bumps and making steps to improve readiness between conflicts, troops’ lives could be saved in the future. These insights were published in a special supplement of the Journal of Trauma and Acute Care Surgery focusing on the military. 

Two soldiers on a field carry a stretcher with a wounded soldier.

“This shows us the big picture of combat casualty outcomes from the beginning of World War II through the modern era, and, at the same time, it also provides significant details on the month-to-month outcomes in each individual war,” says the supplement’s editor and this study’s first author, Jeremy Cannon, the trauma medical director and section chief of trauma, as well as an associate professor of surgery at Penn Medicine. “In all, this is good news because our outcomes have improved significantly over time. However, we see that there is still work to be done—specifically in identifying specific areas for improvement and in keeping our medical corps ready for the next conflict.”

The researchers examined several different metrics for this study: the case fatality rate (CFR)—a measure of the total lethality of the battlefield, which is determined by dividing the total number of combat deaths by the number of combat deaths and combat wounded; the killed in action (KIA) rate— the percentage of combatants who died before hospitalization; and the died of wounds (DOW) rate—the percentage of those wounded who died after receiving hospital-level care.

Four different conflicts were studied, each required to be at least three years long to properly assess the data: World War II, the Korean War, and Vietnam War, with Operations Enduring Freedom (Afghanistan conflict) and Iraqi Freedom assessed separately as well as together.

Since the start of World War II, the researchers found significant gains across two of their measures. The combat fatality rate fell from 55 to 12% between the start of World War II and the most recent conflicts, as did the KIA rate (52 to 5%). 

However, as the research team dove into the month-to-month outcomes of each conflict, they found instances of major spikes in mortality amid conflicts.

This story is by Frank Otto. Read more at Penn Medicine News.