Operation Inherent Resolve Epidemiological Study of Surgical Cases Role III Combat Support Hospital, 2017-2021

Area of Science:

• Military Medicine
• Surgical Operations
• Conflict Epidemiology

Background:

• Surgical workload during military operations shifts across conflict phases.
• Limited data exist on operative volume and case mix during the transition to stability operations.
• Operation Inherent Resolve (OIR) Phase IV provides a model to study these changes at Role 3 facilities.

Purpose of the Study:

• To evaluate operative volume and case mix at a Role 3 military treatment facility during stability operations (Phase IV) in OIR.
• To analyze the types of surgical procedures and specialties involved.
• To understand the impact of declining overall case volume on surgical readiness.

Main Methods:

• Retrospective review of operative encounters at a Role 3 facility during OIR (February 2017-October 2021).
• Inclusion of all operating room cases, analyzing both battle injuries and disease and nonbattle injury (DNBI) cases.
• Data collection included demographics, anatomic region, procedure, operative time, and surgical specialty.

Main Results:

• 606 operative encounters across 516 patients; mean age 31, 97% male.
• Operative volume declined significantly from 2017 to 2021.
• General surgery (39%) and orthopedic surgery (35.8%) predominated; head and neck cases (26%) were notable. Noncombat conditions remained stable.

Conclusions:

• Despite declining operative volume during Phase IV OIR, case diversity and subspecialty demands persisted.
• Findings underscore the necessity of broadly capable Role 3 facilities during stability operations.
• Developing strategies for surgical readiness in low-volume environments is critical for future military medical planning.