Profiles After Acute Traumatic Injury: The Non-battle Injury Impact on Readiness at a Single Military Treatment Facility

Abstract

ABSTRACT Introduction Physical profiling is critical to the individual medical readiness of all military service members. This classification system provides detailed information about an individual’s functional abilities. Profile information is used in determining whether a service member is medically deployable or non-deployable. Limited research has been conducted on the impact of acute traumatic injuries on duty status and profiles in the non-deployed setting. The purpose of this study was to characterize injured service members presenting to a CONUS MTF emergency department whose acute traumatic injury resulted in a profile. Materials and Methods A retrospective review of patients who presented to the Dwight D. Eisenhower Army Medical Center emergency department with traumatic injuries from January 1, 2019, to December 31, 2019, was performed. Patients were identified by searching electronic encounter records for trauma-specific ICD-10 codes. Returned patient records were then reviewed for active duty status, branch, age, gender, rank, mechanism, protective equipment, substance use, procedures, and disposition. Profiles of soldiers were reviewed for indication and duration. Patients with profiles were compared to those without profiles. Correlation with age was determined by t-test, correlation with profile length was determined by ANOVA, and correlation with the remaining categorical variables was determined with chi-squared analysis. Results Eight hundred and thirty-two service members were reviewed. One hundred and eight (13%) soldiers had a profile. Patients were 23.2% female with no difference between the two groups. Patients were an average of 28.7 years old. The most common mechanisms were physical training (PT) (33.1%) and falls (12.9%). Physical training and motor vehicle collisions were more common in the profile group. Combatives and crush injuries of the hand were less common in the profile group. Major procedures were more common in the profile group, and minor procedures were less common. Admissions, quarters, immediate referrals, and release without limitations were more common in the profile group. The mean duration of profiles was 48.9 days, and 7.4% were permanent. Conclusions Non-battle injuries in the garrison setting are a significant threat to readiness. This analysis of acute traumatic injuries suggests that mechanism of injury was similar to previous reports with PT and falls being most common. Interventions should be targeted at PT and motor vehicle collisions as these were more common in the profile group. This series is also similar to previous reports that extremity injuries are the most common cause of profiles. However, TBIs were more common in our analysis. Further research that encompasses all garrison MTF acute traumatic injuries is needed to define the true impact on readiness and guide development of injury prevention strategies.