First, let me begin by stating that this article deals with a sensitive topic in that it discusses how U.S. military men and women die in battle, and it goes on to note that with improved care and faster evacuation times, a significant number of the combat fatalities in Iraq and Afghanistan could have been prevented.

The article addresses not just the mechanism of injury (for instance, a gunshot wound to the chest), but also the physiological result of that injury (for instance, a tension pneumothorax). And yet, so that we do not forget, each of these statistics corresponds to a fallen serviceman or woman, to someone’s father, mother, son, or daughter.

That is worth keeping in mind as we delve into the subject at hand.

Secondly, the title of this article is gender specific. Yes, women are also dying in battle—more so than ever before, in fact—and this author is all for opening up fully all combat units to women, as well as entering them in the Selective Service, for that matter, in the name of full equality. That is a whole other article, though, and for our purposes here, we shall leave the subject alone.

For the sake of this article, we are using in the title the gender-specific “men,” because the great majority of combat deaths (over 97 percent) are among males, and for the sake of brevity in the article’s title, the word simply fits better. Do not interpret this article as limited only to males, though. Women are being killed on the battlefield too these days, and are included in these statistics.

With that said, just how are men and women dying on the battlefield in the last 16-plus years of American war? Studies have been conducted on this topic, not to find fault, but to look for opportunities to improve combat casualty care. The largest and most significant study on combat fatalities from Iraq and Afghanistan was published in 2012 in the Journal of Trauma and Acute Care Surgery, and titled “Death on the Battlefield (2001-2011): Implications for the Future of Combat Casualty Care,” by Dr. Brian Eastridge, et al.

The Eastridge study focuses on the time period from October 2001 to June 2011. An autopsy conducted by the Armed Forces Medical Examiner System at their facility in Dover, Delaware, is conducted on all U.S. military fatalities resulting from trauma. The autopsy records for all trauma deaths that occurred in individuals deployed to Iraq or Afghanistan during the study period were identified. Of the 4,596 fatalities included in the study, it was noteworthy that 87 percent of the deaths in the study occurred before the wounded service member reached a medical treatment facility where surgical care could be provided. Furthermore, of that 87 percent of deaths that occurred pre-hospital, 24 percent had wounds that were judged to have been “potentially survivable.”

To clarify, consider a sample of 100 combat fatalities: 87 of them will have died before reaching a medical treatment facility (on the field of battle, or while being transported to a hospital). Out of those 87 pre-hospital fatalities, approximately 21 of them could have survived their wounds if their battlefield trauma care and transport time to the hospital had been optimized. The remaining 66 had devastating wounds that were not survivable no matter what care had been provided.