Injuries Sustained During Modern Army Combatives Tournaments.

INTRODUCTION: Injuries sustained during Modern Army Combatives (MAC) tournaments can result in variable recovery time for involved competitors and unpredictable loss of readiness for military units. A paucity of MAC data is available to guide military medical providers and unit commanders on expected injuries or loss of readiness. Literature reviewing mixed martial arts competitions offers some insight but demonstrates variation in fight outcomes resulting in injuries ranging from 8.5% to 70% and it is difficult to effectively extrapolate such data to predict MAC tournament injuries. MATERIALS AND METHODS: This study retrospectively reviews pre- and post-competition medical records from two MAC tournaments held at Fort Hood in 2014 and 2015 to provide descriptive clinical information on injury patterns to practitioners and military commanders. RESULTS: Records from a total of 195 competitors with a mean age of 24.4 yr were analyzed with a total of 67 injuries, 29 of which resulted in duty limitations (14.8% of participants). Competitors participating in less-restrictive mixed martial arts style fighting (Advanced MAC) were 4.3 times more likely to sustain an injury than those limited to upper body grappling events (95% confidence interval 2.30-8.16). Military Acute Concussion Evaluations were reliably recorded both pre- and post-competition in 44% of total participants with no significant statistical difference between pre- and post-tournament evaluations. Duty profile limitations of injured competitors averaged 1 mo in duration. CONCLUSIONS: MAC tournaments result in injury rates comparable with other combative sports and military training courses.

An association between Emergency Medicine residencies and improved trauma patient outcome.

A study was done to compare trauma patient outcome at American College of Surgeons (ACS) Level l Trauma Centers with Emergency Medicine residency programs (EMRP+) to those without (EMRP-). Ten Level l Trauma Centers were reviewed from the ACS National Trauma Database (5 centers with and 5 without EM residency programs). Of 18,591 trauma patient records, 8679 were identified as EMRP-, and 9912 as EMRP+. After deleting incomplete data sets, 6621 EMRP- and 6150 EMRP+ records remained. Comparisons between patient age, gender, TRISS, complications, deaths, hospital, ICU and ventilator days, and numbers of burns, penetrating and blunt trauma were performed using t-test and chi-square analysis. Despite having a statistically significant older patient population, with more burn and penetrating trauma patients requiring longer ICU stays and longer ventilatory support (p < 0.0001), Emergency Medicine Residency program hospitals had a significantly lower complication rate (5.14% vs. 11.04%, respectively, p < 0.0001), death rate (4.704% vs. 5.479%, respectively, p = 0.0013), and shorter overall hospital stays (Mean 4.94 days, SD +/- 8.74 vs. 6.35 days, SD +/- 11.22, respectively, p < 0.0001) than EMRP- hospitals. The presence of Emergency Medicine residency programs at ACS Level I Trauma Centers is associated with improved trauma patient outcomes.