Statistical Modeling of Combat Mortality Events by Using Subject Matter Expert Opinions and Operation Iraqi Freedom Empirical Results from the Navy–Marine Corps Combat Trauma Registry

In 12 Navy–Marine Corps medical logistics studies and analyses conducted by the Naval Health Research Center (NHRC) and Teledyne Brown Engineering (TBE) over the past 5 years, estimates of battlefield mortality have been a major metric of interest to medical planners. An ongoing concern is how mortality is related to delays in treatment for medical logistics reasons. In this paper, we describe how NHRC and TBE have been developing a statistically based model for mortality since 2003, first starting with panel results from a group of military medical doctors and continuing here with an analysis of empirical injury data from Operation Iraqi Freedom (OIF). The panel results and statistical analysis of life-threatening injury data in OIF from early 2004 to mid-2006 indicate that the Weibull distribution describes the timing of high risk of mortality events in a reasonable manner within surgical medical treatment facilities. The quest for a best-fitting probability distribution with parameters dependent on the casualty flow chain of treatment and evacuation in the theater is ongoing. In reality, combining analytical and subject matter expert (SME) results to model mortality is necessary given the breadth of theater medical delivery systems and general paucity of adequate empirical data in many of the segments of patient flow.