Saturday, January 8, 2011

In Wider War in Afghanistan

In Wider War in Afghanistan, Survival Rate of Wounded Rises.

Intensified fighting and a larger troop presence in Afghanistan in 2010 led to the highest American combat casualties yet in the war, as the number of troops wounded by bullets, shrapnel and bombs approached that of the bloodiest periods of the war in Iraq.

But the available data points to advances in the treatment of the fallen, as the rate at which wounded soldiers who died reached a wartime low.

More than 430 American service members died from hostile action in Afghanistan last year through Dec. 21, according to official data released by the Pentagon last week at the request of The New York Times.

This was a small fraction of those struck. Nearly 5,500 American troops were wounded in action — more than double the total of 2,415 in 2009, and almost six times the number wounded in 2008.

In all, fewer than 7.9 percent of the Americans wounded in 2010 died, down from more than 11 percent the previous year and 14.3 percent in 2008.

The fatality rate declined even though many more troops patrolled on foot, exposing the force to greater dangers than in years past. Several doctors said the improvements came not from a single breakthrough but through a series of lessons learned over nearly a decade of fighting two wars, such as placing medevac helicopters closer to the fighting and the more extensive use of tourniquets.

Although fatality rates for wounded Afghan troops are not similarly available, doctors involved in their care said hospital records showed that they trail those of Western troops by a few percentage points, but have also fallen.

Several soldiers and those who care for them framed the improved survival rates as the grimmest sort of success. Many more troops — some missing multiple limbs or their genitals, or suffering brain damage — are being rescued from near death. But their wounds will be exceptionally difficult to overcome later as they try to resume work, and social and family lives.

Along with interviews with medics and military doctors, and a month spent by two journalists from The Times observing the collection and immediate treatment of troops suffering from a wide range of trauma, the data shows the results, in broad terms, of an evolving contest for wounded soldiers’ fates.

The contest pits a multilayered and expensive effort to keep troops alive against the sharply increased rate at which they suffer grievous injuries, some beyond what any medical system can heal.

A clear decline was evident: In 2005, 19.8 percent of wounded American soldiers died from their injuries. For the past five years in Afghanistan and Iraq, the fatality rates for wounded Americans have otherwise fluctuated between 9.4 and 14.3 percent.

(The data draws from a sample running into the tens of thousands; in 2006 in Iraq, for example, nearly 7,200 American troops were wounded by hostile action, more than 700 of them fatally.)

The statistics further served to reinforce consistent trends in the battlefield’s array of lethal hazards, and offered glimpses of wars within the war.

More soldiers in Afghanistan in 2010 were wounded by explosive devices (at least 3,615, compared to 828 troops reported to suffer gunshot wounds). But the higher fatality rates from gunshot wounds (12.9 percent versus 7.3 percent for wounds caused by bombs) made rifles and machine guns the most statistically deadly weapons.

Rocket-propelled grenades, for all their ferocious reputation, proved less of a threat. They wounded 373 American soldiers, of whom 13 — 3.5 percent — died.

No matter the improved odds, the data, like the field observations, illuminated that even the most determined efforts to cheat death could still be desperate — like the case of an Afghan soldier wounded on Dec. 9.

He was a disoriented young man on a stretcher with his uniform cut away, revealing wounds caused by a makeshift bomb.

His face was mashed. A tourniquet was cinched to his left leg, high by the hip. His abdomen swelled slightly from the bleeding within. From his torso rose the odor of burned flesh and hair.

The man worked with an American Special Forces team. Medics labored over him as the helicopter lifted from the dust, counting minutes in a race against time.

Medical workers attributed his improved chances to several factors, among them changes in training for soldiers who administer first aid, swifter movement of victims to hospitals made possible by more helicopters in the war, and shifts in procedures in operating rooms.

No comments:

Post a Comment