Introduction:

The relationship between mechanisms of injury and injury severity has been widely documented in studies carried out on the civilian population and on terrorist attacks, although these results are difficult to extrapolate to the military environment, due to their inherent characteristics. The objective of this study was to analyze the distribution of the mechanisms of injury and its relationship with injury severity in combat casualty.

Material and methods:

A retrospective, descriptive and cross-sectional study was carried out on all patients injured by firearms or explosives treated in the Spanish Role 2 deployed in Herat between 2005 and 2014.

Results:

A total of 911 combat casualties were analyzed in which the explosive was the main mechanisms of injury in 64.76% of the cases, and the gunshot in 34.68%. The median mNISS scores in casualties injured by gunshot [9 (IQR: 5-19)] was higher than those injured by explosives [6 (IQR: 3-17)]. Furthermore, the distribution of severity levels was different (p = 0.000) depending on the mechanisms of injury.

Conclusions:

Explosives were the main mechanisms of injury among the combat casualties treated in the Spanish Role 2 in Herat, although the casualties with gunshot wounds presented more severe injuries. Our results regarding the distribution of the mechanisms of injury are similar to those published in other series; however, a consensus has not been found in the current literature in which the injury severity of combat casualty has been related to the mechanisms of injury.