Casualty Sex Differences: A New Dilemma in Modern Warfare

CPT Christina Hylden, MD; LTC Anthony Johnson, MD; and MAJ Jessica Rivera, MD

War has evolved over the centuries—from the Greek Phalanx, the Roman Legion, and the British Cavalry to armored regiments, missile defense teams, and naval battalions. Projectile weaponry has advanced from arrows and muskets to high-powered rifles and missiles. War zones have moved from designated lines of conflict with highly visible opponents to guerilla tactics, drone attacks, and inconspicuous (but highly explosive) packages.

With the evolution of weaponry and fighting tactics—as well as the developments in medicine—came a change in the injuries and illnesses that wound and kill soldiers and civilians alike. In the American Civil War, soldiers were more likely to die of dysentery than direct conflict with the enemy. The most recent conflicts in Iraq and Afghanistan have shown casualty survival rates of greater than 90 percent. Advancements in body armor and medical care (both at point of injury and at local base hospitals) have enabled more service members to survive their initial wounds.

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