Decreasing killed in action and died of wounds rates in combat wounded.

Combat Demographics From retrospective analysis, the majority of “potentially survivable” injuries resulting in death on the battlefield and after reaching a surgical facility are caused by hemorrhage.1–3 In combat, hemorrhage is the cause in 83% to 87% of all such potentially survivable deaths. Of these deaths, approximately 50% are attributed to noncompressible hemorrhage from penetrating truncal injury (Fig. 1).2,3 Therefore, the primary target for making a significant impact on death in combat, both before (killed in action [KIA]) and after reaching a deployed surgical facility (died of wounds [DOW]), is to address noncompressible hemorrhage from penetrating truncal injury.4 Because of the potential for prolonged evacuation time during combat operations and the relatively limited options available for treatment of truncal penetrating injury before admission to a surgical facility, the prehospital phase of evacuation offers the greatest opportunity to mitigate the hemorrhagic sequelae of battlefield injury.5,6