Battle Injury Patterns Sustained Noncombatant Military Occupational Specialty Service Members

The US military has been engaged in the Global War on Terrorism for nearly 2 decades. This asymmetric warfare has exposed many noncombat military occupational specialties (MOS) personnel to combat. We assessed what proportion of casualties were combat versus noncombat MOS personnel.

This is a secondary analysis of a previously described dataset from the Department of Defense Trauma Registry (DODTR). We included US military casualties sustaining battle injuries from January 2007 to March 2020 with a documented MOS. We classified each casualty as combat versus noncombat MOS personnel.

There were 2,037 casualties who met inclusion for this analysis. Within these groups, there were 1,554 (76%) combat and 483 (24%) noncombat personnel. The median ages were 24 and 25, with more males among the combat MOS personnel (99% versus 93%). Army personnel comprised the largest proportion of both groups (78% versus 75%) with most injured by explosive (73% versus 78%). Median injury severity scores were similar (9 in both groups) as was survival (98% versus 98%). The annual proportion of battle injuries comprised of noncombat MOS personnel fluctuated year-to-year. The proportion of noncombat personnel with a medic in their chain of care was similar to combat personnel (25% versus 26%), as was the proportion undergoing medical evacuation by ground (11% versus 11%) or air (87% versus 86%). All prehospital interventions occurred in similar proportions except for ketamine administration (8% combat versus 3% noncombat MOS personnel).

Our study showed noncombat MOS personnel comprised nearly one in four casualties. Injury patterns were similar between combat and noncombat MOS personnel with nearly identical consumption of resources except for ketamine. More data is necessary on noncombatant MOS personnel battle injury patterns to guide commanders and medical leaders for future mission planning in resource constrained environments.