Review of Military Casualties in Modern Conflicts—The Re-emergence of Casualties From Armored Warfare

Abstract

Introduction The re-emergence of armored warfare in modern conflicts has resulted in a higher number of extremity injuries, burns, and brain injuries. Despite this dramatic increase, little is reported on the type of injuries caused and their management. This review summarizes the publicly available literature and reports on the rate and type of injuries related to armored warfare, their medical outcomes, and management limitations. Materials and Methods This rapid evidence review involves a systematic literature search, followed by a non-systematic literature review. The reason for choosing this approach was the inherent lack of quantitative outcome data in the literature to satisfy the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The study also used content analysis to study all peer-reviewed articles, focusing on similarities and differences in the findings necessary to formulate tentative results. The electronic search included PubMed, Scopus, and Web of Science, using the following search string: “Armored; Injuries; Mechanized; Morbidity; Mortality; War; Warfare”, alone or in combination. Results Modern conflicts are associated with higher number of extremity injuries, burns, and brain injuries among military casualties. Several publications claim that the characteristics of armored warfare and anticipated injuries in this type of warfare might require the far forward deployment of medical support supported by a reliable casualty evacuation chain. Still the quality of the available casualty data is low. Conclusions Because of the limited availability of reliable data or military trauma registries, up-to-date military casualty estimation remains a recognized knowledge gap, which needs to be addressed by armed forces worldwide. The future management of modern war casualties requires professional and well-trained staff in all levels, indicating a need for educational initiatives to provide both nurses and medics a greater proportion of medical care and management capabilities and responsibilities than in past conflicts.

The Influence of War and Conflict on Infectious Disease: A Rapid Review of Historical Lessons We Have Yet to Learn

“…When the current pandemic occurred the World Health Organization declared that there is "no going back to normal." Only a totally new global public health infrastructure management system supported by a global public health database can possibly begin to address the immense infectious disease challenges ahead, many of which will become increasingly violent [89][90][91][92].…”

Estimating the Number of Civilian Casualties in Modern Armed Conflicts–A Systematic Review

“…While the internal structure of states can be intact in a majority of traditional wars (may not apply to invaded nations), these entities are no longer functioning effectively in many armed conflicts. In contrast to traditional wars, modern armed conflicts target the local structures, organizations, and public services and aim at destabilizing the authorities and societal networks (13,30,31,41,(43)(44)(45). Warfare in the 21st century constitutes multi-domain operations, asymmetry, and a hybrid approach (19)(20)(21)(22).…”

“…Both traditional wars and modern armed conflicts have crucial impacts on society and result in material destruction and human losses. One way to evaluate the destructive outcomes of a war or an armed conflict is to estimate its impacts on human life (12)(13)(14)(15)(16)(17)(18). Knowing the utilized military means and strategies and their anatomical and physiological impacts on the human body along with registered data regarding the number and type of injuries from previous wars, the outcomes of a traditional war, in terms of mortality, morbidity, and the number of casualties has long been predictable, recorded, and debated (14)(15)(16)(17).…”

“…The information provides a reasonable ground for mental and practical preparedness before a war. This readiness has enabled estimation of needed resources for immediate assessment, treatment, and transport of victims, and has resulted in the development of military medicine, pre-hospital care, and mass casualty (injured and or killed) management (12,13).…”

“…The inability to estimate the casualty rate (16,17) influences the calculation of needed resources, which creates a troublesome situation for the affected state and international help organizations. Particularly, the national healthcare contingencies organizations are dependent on predictions of medical support and resources needed to treat casualties (9,10,13,26). Currently, casualty calculation relies mainly on registered and recorded data from earlier conflicts.…”