U.S. Army Injury Surveillance Summary 2014
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1 U.S. Army Injury Surveillance Summary 2014 Epidemiology and Disease Surveillance Portfolio Injury Prevention Program Website: Approved for Public Release Distribution Unlimited
2 Injury Pyramid, U.S. Army Active Duty, 2014 Frequency 180 Death Ratio 1 3,000 Hospitalizations ,000 Ambulatory/Outpatient 3,489 Frequencies are rounded 2
3 Relative Burden of Injuries and Diseases, U.S. Army Active Duty, 2014 ICD-9-CM Code Groups Injury Mental Ill-defined conditions Musculoskeletal Resp infections Sense organ Skin Genitourinary Resp disease Digestive Infect/Parasite Other* Medical encounters Individuals affected Hospital bed days Medical Encounters/Individuals Affected *Includes all ICD-9-CM code groups with less than 80,000 medical encounters Diagnosis group Injury contains both injury and injury-related musculoskeletal conditions 3
4 U.S. Army Active Duty vs. Trainee Overall Injury Visit Rates, Rate per 1,000 PY Trainee Active Duty Active Duty injury adjusted to remove deployed injury and deployed person-time 4
5 U.S. Army Active Duty Injury and Overuse Injury Visit Rates, Rates per 1,000 PY All Injuries Overuse Injuries Active Duty injury adjusted to remove deployed injury and deployed person-time Overuse injuries of the lower extremity 5
6 U.S. Army Trainee Injury and Overuse Injury Visit Rates, Rates per 1,000 PY All Injuries Overuse Injuries Overuse injury of the lower extremity 6
7 Conditions Resulting in Hospitalization Top 10 ICD-9 Categories, U.S. Army Active Duty, 2014 Mental 24.6 Percent (%) of Hospitalizations Pregnancy Injury & Msk Gastrointestinal Ill-defined Msk (non-injury) Circulatory Genitourinary Respiratory Nervous Total number of incident hospitalizations = 30,840 7
8 Injuries vs. Illnesses Resulting in Outpatient Visits, Top 10 ICD-9 Categories, U.S. Army Active Duty, 2014 Injury & Msk 27.2 Percent (%) of Outpatient Visits Ill-defined Nervous Mental Msk (non-injury) Respiratory Skin & Subcut Gastrointestinal Genitourinary Infect/Parasite Total number of incident outpatient visits = 2,307,011 8
9 Leading Causes of Unintentional Hospitalizations by Cause, U.S. Army Active Duty, Percent (%) of All Causes Total number of cause-coded unintentional injury hospitalizations = 963 Land transport includes both traffic and nontraffic related and military and nonmilitary related incidents 9
10 Leading Causes of Unintentional Injury Outpatient Visits by Cause, U.S. Army Active Duty, Percent (%) of All Causes Overexertion Fall Struck by/against Transport Cut/Pierce Natural/Environ Total number of cause-coded unintentional outpatient visits = 73,379 10
11 Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations, U.S. Army Active Duty, 2014 BODY REGION Head and Neck Spine and Back Torso Extremities Unclass. by Site Traumatic Brain Injury (TBI) Other Head, Face, Neck Spinal Cord (SCI) Vertebral Column (VCI) Torso Upper Lower Other, Unspecified DIAGNOSIS Fracture Dislocation Sprains/ Strains Internal Open Wound Amputations Blood Vessel Contusion/ Superficial Crush Burns Nerves Unspec Total Type 1 TBI Type 2 TBI Type 3 TBI TBI Unspec Other head Face Eye Neck Head, Face, Neck Unspec Cervical SCI Thoracic/Dorsal SCI Lumbar SCI Sacrum Coccyx SCI Spine, Back Unspec. SCI Cervical VCI Thoracic/Dorsal VCI Lumbar VCI Sacrum Coccyx VCI Spine, Back Unspec. VCI Chest (thorax) Abdomen Pelvis, Urogenital Trunk Back, Buttock Shoulder, Upper Arm Forearm, Elbow Wrist, Hand, Fingers Other & Unspec Hip Upper leg, Thigh Knee Lower leg, Ankle Foot, toes Other & Unspec Systemwide & late effects 29.4% Other/Multiple % Unspec. Site % System-wide & late effects % Total , % % Total 44.7% 3.5% 7.4% 13.2% 8.2% 0.4% 0.5% 3.5% 0.6% 2.7% 0.4% 4.1% 10.6% 100% % by body region 12.8% 10.3% 0.8% 4.5% 10.5% 18.3% 11
12 Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits, U.S. Army Active Duty, 2014 BODY REGION Head and Neck Spine and Back Torso Extremities Unclass. by Site Traumatic Brain Injury (TBI) Other Head, Face, Neck Spinal Cord (SCI) Vertebral Column (VCI) Torso Upper Lower DIAGNOSIS Fracture Dislocation Sprains/ Strains Internal Open Wound Amputations Blood Vessel Contusion/ Superficial Crush Burns Nerves Unspec Total Type 1 TBI , ,846 Type 2 TBI , ,335 Type 3 TBI , ,638 TBI Unspec Other head , ,140 Face 1, , ,268 Eye , ,953 Neck Head, Face, Neck Unspec , , ,133 Cervical SCI Thoracic/Dorsal SCI Lumbar SCI Sacrum Coccyx SCI Spine, Back Unspec. SCI Cervical VCI , ,668 Thoracic/Dorsal VCI , ,833 Lumbar VCI , ,900 Sacrum Coccyx VCI Spine, Back Unspec. VCI Chest (thorax) , , ,758 Abdomen Pelvis, Urogenital , ,379 Trunk , , ,049 Back, Buttock 0 0 2, ,757 Shoulder, Upper Arm 899 1,927 15, , ,694 Forearm, Elbow 1, ,642 Wrist, Hand, Fingers 5, , , , , ,719 Other & Unspec , ,020 Hip , ,186 Upper leg, Thigh Knee 166 3,843 3, , ,268 Lower leg, Ankle 2, , ,366 Foot, toes 3, , , , ,770 Other & Unspec , , , , ,352 Systemwide & late effects 38.7% Other, Other/Multiple % Unspecified Unspec. Site , , , , , % System-wide & late effects ,723 5, % Total 18,431 7,009 96,695 7,380 17, , , ,929 5, , % % Total 8.8% 3.3% 46.0% 3.5% 8.2% 0.2% 0.1% 15.1% 0.4% 0.9% 0.4% 10.4% 2.7% 100% % by body region 4.7% 6.5% 0.1% 6.6% 7.8% 26.2% 12
13 Frequency of Injury-related Musculoskeletal Conditions by Location and Diagnosis Hospitalizations, U.S. Army Active Duty, 2014 DIAGNOSIS Injury Location Inflammation and Pain (Overuse) Joint Derangement Joint Derangement with Neurological Involvement Stress Fracture Sprains/ Strains/ Rupture Dislocation Total % by body region Cervical Thoracic/Dorsal Vertebral Column Lumbar % Sacrum, Coccyx Spine, Back Unspecified Shoulder BODY REGION Extremities Upper Lower Upper arm, Elbow Forearm, Wrist Hand Pelvis, Hip, Thigh Knee, Lower leg % 26.3% Unclassified by Site Others and Unspecified Ankle, Foot Other specified/multiple Unspecified Site Total , % 3.0% % Total
14 Frequency of Injury-related Musculoskeletal Conditions by Location and Diagnosis Outpatient Visits, U.S. Army Active Duty, 2014 DIAGNOSIS Injury Location Inflammation and Pain (Overuse) Joint Derangement Joint Derangement with Neurological Involvement Stress Fracture Sprains/ Strains/ Rupture Dislocation Total % by body region Cervical 20,587 2,280 3, ,056 Thoracic/Dorsal , ,799 Vertebral Column Lumbar 73,862 9,577 2, ,085 Sacrum, Coccyx 3, ,848 Spine, Back Unspecified 11,994 1, , % Shoulder 52,280 4, ,874 BODY REGION Extremities Upper Lower Upper arm, Elbow 8, ,676 Forearm, Wrist 9, ,297 Hand 4, , % Pelvis, Hip, Thigh 22, ,861 Knee, Lower leg 82,335 6, ,730 3, ,436 Unclassified by Site Others and Unspecified Ankle, Foot 57,215 3, , % Other specified/multiple 1, ,401 Unspecified Site 10, , , % Total 359,498 29,315 11,843 3,058 4, , % % Total
15 Disclaimer The views expressed in this presentation are those of the author(s) and do not necessarily reflect the official policy of the Department of Defense, Department of the Army, U.S. Army Medical Department or the U.S. 15
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