Defining and predicting surgeon utilization at forward surgical teams in Afghanistan

Kyle N. Remick, James A. Dickerson, Daniel Cronk, Richard Topolski, Shawn C. Nessen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The forward surgical team (FST) is the US Army's smallest surgical element. These teams have supported current conflicts since 2001. The purpose of this study was to determine if surgeon utilization varied at two different FSTs and to determine factors that may predict the need for a surgeon. Method: Data from two FSTs were reviewed. A t-test was used to compare the military injury severity scores (mISS) and the revised trauma scores (RTS). χ2 analysis was used to compare types and mechanisms of injury and to compare life- or limb-saving surgeries (LLSS) and life-saving interventions among the FSTs. Logistic regression was used to determine if mISS, RTS, physiologic parameters, or laboratory values predicted the need for LLSS or life-saving intervention. Results: The 541st FST treated a larger volume of patients than the 772nd FST (n = 761 versus n = 311). The 772nd FST performed a significantly higher percentage of LLSS; however, absolute number of LLSS was 31 at both FSTs. The mISS among operative patients were similar, but RTS were significantly different (772nd FST = 7.28 versus 541st FST = 7.58, P = 0.008). The 772nd FST saw a higher percentage of motor vehicle collision and rocket-propelled grenade injuries and thoracic and neurologic injuries, and the 541st FST saw a higher percentage of blast and gunshot wound injuries and abdominal injuries. Lactate level was the most significant predictor of the need for LLSS. Conclusion: Although percentage of surgical interventions varied between the two FSTs, the absolute number of needed surgical interventions was the same and was small. Lactate level predicted the need for surgical intervention in our population.

Original languageEnglish (US)
Pages (from-to)282-287
Number of pages6
JournalJournal of Surgical Research
Volume177
Issue number2
DOIs
StatePublished - Oct 1 2012

Fingerprint

Afghanistan
Extremities
Injury Severity Score
Wounds and Injuries
Lactic Acid
Nervous System Trauma
Abdominal Injuries
Gunshot Wounds
Thoracic Injuries
Motor Vehicles
Surgeons
Logistic Models
Population

Keywords

  • Afghanistan
  • Forward surgical team (FST)
  • Lactate
  • Life- or limb-saving surgery (LLSS)
  • Life-saving intervention (LSI)
  • Surgeon utilization

ASJC Scopus subject areas

  • Surgery

Cite this

Defining and predicting surgeon utilization at forward surgical teams in Afghanistan. / Remick, Kyle N.; Dickerson, James A.; Cronk, Daniel; Topolski, Richard; Nessen, Shawn C.

In: Journal of Surgical Research, Vol. 177, No. 2, 01.10.2012, p. 282-287.

Research output: Contribution to journalArticle

Remick, Kyle N. ; Dickerson, James A. ; Cronk, Daniel ; Topolski, Richard ; Nessen, Shawn C. / Defining and predicting surgeon utilization at forward surgical teams in Afghanistan. In: Journal of Surgical Research. 2012 ; Vol. 177, No. 2. pp. 282-287.
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