Surgical Capability Utilization Time for Military Casualties at Role 2 and Role 3 Facilities

Operative capability utilization time for casualties is an important metric for trauma planning in the military. Operative capabilities can be a choke point resulting in multiple patients waiting for the asset to become available during mass casualty events. The objective measurement of how long deployed operative capabilities are utilized for various categories of injury has not been described. This study provides the measurements for role 2 and role 3 facilities.

The Department of Defense Trauma Registry was sampled for each composite injury severity score (ISS) category in the registry (mild, moderate, severe, and critical). Thirty randomly selected samples for role 2 and role 3 facilities for each composite ISS category with an anesthesia record including a start and end time for the index surgical case were included.

There were no statistical differences between role 2 and role 3 facility operative capability utilization times for any composite ISS category. The mean time (min) for mild, moderate, severe, and critical for role 2 and role 3 was 93.9 and 96.3, 142.2 and 144.3, 177.4 and 171.1, 182.9 and 205.6, respectively. The proportion of Department of Defense Trauma Registry surgical patients who were mild, moderate, severe, or critical were 57.5%, 18.2%, 13.6%, and 10.7%, respectively.

There is no statistical difference between roles of care in operative asset utilization time. The provided operative capability utilization times will be useful for casualty management planning and improvement initiatives.