U.S. Army Injury Surveillance Summary 2015 Library...U.S. Army Public Health Center UNCLASSIFIED...
39
UNCLASSIFIED (For Public Release) Epidemiology and Disease Surveillance Portfolio Injury Prevention Division Website: http://phc.amedd.army.mil/organization/hq/deds/Pages/InjuryPreventionProgram.aspx Email: [email protected]U.S. Army Injury Surveillance Summary 2015
U.S. Army Injury Surveillance Summary 2015 Library...U.S. Army Public Health Center UNCLASSIFIED (For Public Release) Injury Pyramid, U.S. Army Active Duty, 2015 Death Hospitalizations
UNCLASSIFIED (For Public Release)US Army Public Health Center
Disclaimer
The views expressed in this presentation are those of the author(s) and do not necessarily reflect the official policy of the Department of Defense Department of the Army US Army Medical Department or the US
2
UNCLASSIFIED (For Public Release)US Army Public Health Center
Injury Pyramid US Army Active Duty 2015
Death
Hospitalizations
AmbulatoryOutpatient
1
Ratio
260
4000
Frequencydagger
15
2523656000
daggerFrequencies are roundedData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
3
Presenter
Presentation Notes
Summary of accidental injury casualties for 2015 13In 2015 there were approximatelymdash13260 injury-related deaths134000 injury-related hospitalizations (includes acute injury and injury-related musculoskeletal conditions)13656000 injury-related outpatient visits 13For every 1 injury-related death there were 15 hospitalizations and 2523 outpatient visits 13Fatalities have been a major focus of injury prevention activities in the past As illustrated by these data however there are far more injury-related hospitalizations and outpatient visits that occur than deaths These nonfatal outcomes result in significant losses in duty time and manpower for the Army 13
260
4000
Frequencydagger
15
2523
656000
1
Ratio
Unintentional Injury Pyramid AD Army 2006
Unintentional Injury Pyramid AD Army 2006
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Includes all ICD-9-CM code groups with less than 82000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
4
Other
Digestive
Resp disease
InfectParasite
Genitourinary
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encounters
Individuals affected
Hospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) 13In 2015 there were 4820679 medical encounters (hospitalizations and outpatient visits)mdash13Injuries accounted for 247 percent of all medical encounters (n=1189087) about 12 times as many encounters as the second leading cause mental disorders (n=1018578 211 percent)13Injuries affected 273045(195 percent) 14 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 188579 135 percent) 13Mental disorders (n=69746) required the most hospital bed days followed by injuries (n=21483) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Includes all ICD-9-CM code groups with less than 60000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
5
Other
Resp disease
InfectParasite
Digestive
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) for males 13In 2015 there were 3761324 medical encounters (hospitalizations and outpatient visits) for malesmdash13Injuries accounted for 256 percent of all medical encounters (n=964256) about 12 times as many encounters as the second leading cause mental disorders (n=804032 214 percent)13Injuries affected 226704(206 percent) 15 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 150220 137 percent) 13Mental disorders (n=55650) required the most hospital bed days followed by injuries (n=18837) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
Includes all ICD-9-CM code groups with less than 25000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
6
Other
InfectParasite
Neurologic
Resp infections
Sense organ
Skin
Genitourinary
Maternal
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) in females 13In 2015 there were 1059355 medical encounters (hospitalizations and outpatient visits) for femalesmdash13Injuries accounted for 212 percent of all medical encounters (n=224831) slightly more encounters than the second leading cause mental disorders (n=214546 203 percent)13Injuries affected 46341 (156 percent) 12 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 38359 129 percent) 13Maturnity (n=20279) required the most hospital bed days followed by mental disorders (n=14096) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Disclaimer
The views expressed in this presentation are those of the author(s) and do not necessarily reflect the official policy of the Department of Defense Department of the Army US Army Medical Department or the US
2
UNCLASSIFIED (For Public Release)US Army Public Health Center
Injury Pyramid US Army Active Duty 2015
Death
Hospitalizations
AmbulatoryOutpatient
1
Ratio
260
4000
Frequencydagger
15
2523656000
daggerFrequencies are roundedData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
3
Presenter
Presentation Notes
Summary of accidental injury casualties for 2015 13In 2015 there were approximatelymdash13260 injury-related deaths134000 injury-related hospitalizations (includes acute injury and injury-related musculoskeletal conditions)13656000 injury-related outpatient visits 13For every 1 injury-related death there were 15 hospitalizations and 2523 outpatient visits 13Fatalities have been a major focus of injury prevention activities in the past As illustrated by these data however there are far more injury-related hospitalizations and outpatient visits that occur than deaths These nonfatal outcomes result in significant losses in duty time and manpower for the Army 13
260
4000
Frequencydagger
15
2523
656000
1
Ratio
Unintentional Injury Pyramid AD Army 2006
Unintentional Injury Pyramid AD Army 2006
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Includes all ICD-9-CM code groups with less than 82000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
4
Other
Digestive
Resp disease
InfectParasite
Genitourinary
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encounters
Individuals affected
Hospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) 13In 2015 there were 4820679 medical encounters (hospitalizations and outpatient visits)mdash13Injuries accounted for 247 percent of all medical encounters (n=1189087) about 12 times as many encounters as the second leading cause mental disorders (n=1018578 211 percent)13Injuries affected 273045(195 percent) 14 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 188579 135 percent) 13Mental disorders (n=69746) required the most hospital bed days followed by injuries (n=21483) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Includes all ICD-9-CM code groups with less than 60000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
5
Other
Resp disease
InfectParasite
Digestive
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) for males 13In 2015 there were 3761324 medical encounters (hospitalizations and outpatient visits) for malesmdash13Injuries accounted for 256 percent of all medical encounters (n=964256) about 12 times as many encounters as the second leading cause mental disorders (n=804032 214 percent)13Injuries affected 226704(206 percent) 15 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 150220 137 percent) 13Mental disorders (n=55650) required the most hospital bed days followed by injuries (n=18837) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
Includes all ICD-9-CM code groups with less than 25000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
6
Other
InfectParasite
Neurologic
Resp infections
Sense organ
Skin
Genitourinary
Maternal
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) in females 13In 2015 there were 1059355 medical encounters (hospitalizations and outpatient visits) for femalesmdash13Injuries accounted for 212 percent of all medical encounters (n=224831) slightly more encounters than the second leading cause mental disorders (n=214546 203 percent)13Injuries affected 46341 (156 percent) 12 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 38359 129 percent) 13Maturnity (n=20279) required the most hospital bed days followed by mental disorders (n=14096) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Injury Pyramid US Army Active Duty 2015
Death
Hospitalizations
AmbulatoryOutpatient
1
Ratio
260
4000
Frequencydagger
15
2523656000
daggerFrequencies are roundedData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
3
Presenter
Presentation Notes
Summary of accidental injury casualties for 2015 13In 2015 there were approximatelymdash13260 injury-related deaths134000 injury-related hospitalizations (includes acute injury and injury-related musculoskeletal conditions)13656000 injury-related outpatient visits 13For every 1 injury-related death there were 15 hospitalizations and 2523 outpatient visits 13Fatalities have been a major focus of injury prevention activities in the past As illustrated by these data however there are far more injury-related hospitalizations and outpatient visits that occur than deaths These nonfatal outcomes result in significant losses in duty time and manpower for the Army 13
260
4000
Frequencydagger
15
2523
656000
1
Ratio
Unintentional Injury Pyramid AD Army 2006
Unintentional Injury Pyramid AD Army 2006
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Includes all ICD-9-CM code groups with less than 82000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
4
Other
Digestive
Resp disease
InfectParasite
Genitourinary
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encounters
Individuals affected
Hospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) 13In 2015 there were 4820679 medical encounters (hospitalizations and outpatient visits)mdash13Injuries accounted for 247 percent of all medical encounters (n=1189087) about 12 times as many encounters as the second leading cause mental disorders (n=1018578 211 percent)13Injuries affected 273045(195 percent) 14 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 188579 135 percent) 13Mental disorders (n=69746) required the most hospital bed days followed by injuries (n=21483) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Includes all ICD-9-CM code groups with less than 60000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
5
Other
Resp disease
InfectParasite
Digestive
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) for males 13In 2015 there were 3761324 medical encounters (hospitalizations and outpatient visits) for malesmdash13Injuries accounted for 256 percent of all medical encounters (n=964256) about 12 times as many encounters as the second leading cause mental disorders (n=804032 214 percent)13Injuries affected 226704(206 percent) 15 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 150220 137 percent) 13Mental disorders (n=55650) required the most hospital bed days followed by injuries (n=18837) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
Includes all ICD-9-CM code groups with less than 25000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
6
Other
InfectParasite
Neurologic
Resp infections
Sense organ
Skin
Genitourinary
Maternal
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) in females 13In 2015 there were 1059355 medical encounters (hospitalizations and outpatient visits) for femalesmdash13Injuries accounted for 212 percent of all medical encounters (n=224831) slightly more encounters than the second leading cause mental disorders (n=214546 203 percent)13Injuries affected 46341 (156 percent) 12 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 38359 129 percent) 13Maturnity (n=20279) required the most hospital bed days followed by mental disorders (n=14096) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Includes all ICD-9-CM code groups with less than 82000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
4
Other
Digestive
Resp disease
InfectParasite
Genitourinary
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encounters
Individuals affected
Hospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) 13In 2015 there were 4820679 medical encounters (hospitalizations and outpatient visits)mdash13Injuries accounted for 247 percent of all medical encounters (n=1189087) about 12 times as many encounters as the second leading cause mental disorders (n=1018578 211 percent)13Injuries affected 273045(195 percent) 14 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 188579 135 percent) 13Mental disorders (n=69746) required the most hospital bed days followed by injuries (n=21483) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Includes all ICD-9-CM code groups with less than 60000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
5
Other
Resp disease
InfectParasite
Digestive
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) for males 13In 2015 there were 3761324 medical encounters (hospitalizations and outpatient visits) for malesmdash13Injuries accounted for 256 percent of all medical encounters (n=964256) about 12 times as many encounters as the second leading cause mental disorders (n=804032 214 percent)13Injuries affected 226704(206 percent) 15 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 150220 137 percent) 13Mental disorders (n=55650) required the most hospital bed days followed by injuries (n=18837) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
Includes all ICD-9-CM code groups with less than 25000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
6
Other
InfectParasite
Neurologic
Resp infections
Sense organ
Skin
Genitourinary
Maternal
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) in females 13In 2015 there were 1059355 medical encounters (hospitalizations and outpatient visits) for femalesmdash13Injuries accounted for 212 percent of all medical encounters (n=224831) slightly more encounters than the second leading cause mental disorders (n=214546 203 percent)13Injuries affected 46341 (156 percent) 12 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 38359 129 percent) 13Maturnity (n=20279) required the most hospital bed days followed by mental disorders (n=14096) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Includes all ICD-9-CM code groups with less than 60000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
5
Other
Resp disease
InfectParasite
Digestive
Resp infections
Skin
Sense organ
Neurologic
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) for males 13In 2015 there were 3761324 medical encounters (hospitalizations and outpatient visits) for malesmdash13Injuries accounted for 256 percent of all medical encounters (n=964256) about 12 times as many encounters as the second leading cause mental disorders (n=804032 214 percent)13Injuries affected 226704(206 percent) 15 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 150220 137 percent) 13Mental disorders (n=55650) required the most hospital bed days followed by injuries (n=18837) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
Includes all ICD-9-CM code groups with less than 25000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
6
Other
InfectParasite
Neurologic
Resp infections
Sense organ
Skin
Genitourinary
Maternal
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) in females 13In 2015 there were 1059355 medical encounters (hospitalizations and outpatient visits) for femalesmdash13Injuries accounted for 212 percent of all medical encounters (n=224831) slightly more encounters than the second leading cause mental disorders (n=214546 203 percent)13Injuries affected 46341 (156 percent) 12 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 38359 129 percent) 13Maturnity (n=20279) required the most hospital bed days followed by mental disorders (n=14096) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
Includes all ICD-9-CM code groups with less than 25000 medical encountersDiagnosis group Injury contains both injury and injury-related musculoskeletal conditionsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
6
Other
InfectParasite
Neurologic
Resp infections
Sense organ
Skin
Genitourinary
Maternal
Ill-defined conditions
Musculoskeletal
Mental health
Injury
Medical EncountersIndividuals Affected
ICD-
9-CM
Cod
e G
roup
s
Medical encountersIndividuals affectedHospital bed days
Presenter
Presentation Notes
Illustrates the frequency of injuries and disease by primary diagnosis (ICD-9-CM code groups) in females 13In 2015 there were 1059355 medical encounters (hospitalizations and outpatient visits) for femalesmdash13Injuries accounted for 212 percent of all medical encounters (n=224831) slightly more encounters than the second leading cause mental disorders (n=214546 203 percent)13Injuries affected 46341 (156 percent) 12 times more individuals than the second leading diagnosis group ill-defined signs and symptoms (n= 38359 129 percent) 13Maturnity (n=20279) required the most hospital bed days followed by mental disorders (n=14096) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
7
Presenter
Presentation Notes
Compares rates of all injury visits among non-deployed Active Duty Soldiers and trainees for 2007ndash2015 13The Active Duty injury rate raised slightly 2007 to 2015 (13 increase) 13The trainee injury visit rate decreased 42 from 2007 to 2015 (2842 visits per 1000 person-years to 1643 visits per 1000 person-years) There was a slight increase from 2009 to 2011 (2229 to 2328 visits per 1000 person-years)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
8
Presenter
Presentation Notes
Compares rates of all injury visits among male non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The male Active Duty injury rate steadily increased from 2009 to 2015 (26 increase 1017 visits per 1000 person-years in 2009 to 1284 visits per 1000 person-years in 2015) 13The male trainee injury visit rate decreased 29 from 2009 to 2015 (1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
TraineeActive Duty
Rat
e pe
r 10
00 P
Y
Active Duty injury adjusted to remove deployed injury and deployed person-timeData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
9
Presenter
Presentation Notes
Compares rates of all injury visits among female non-deployed Active Duty Soldiers and trainees for 2009ndash2015 13The female Active Duty injury rate slightly increased from 2009 to 2015 (21 increase 1418 visits per 1000 person-years in 2009 to 1721 visits per 1000 person-years in 2015) 13The female trainee injury visit rate increased 21 from 2009 to 2011 and then decreased back a slightly smaller rate than 2009 (3960 visits per 1000 person-years in 2009 to 3013 visits per 1000 person-years in 2015)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
10
Presenter
Presentation Notes
Illustrates rates of all injury visits among non-deployed Active Duty Soldiers from 2007ndash2015 13Injury visit rates have been consistently over 1200 visits per 1000 Soldiers per year throughout this 9-year period13Rates of injury visits fluctuated between 2007 and 2015 with a peak rate of 1365 visits per 1000 person-years in 2010 Overall there was a slight increase from 1234 per 1000 person-years in 2007 to 1346 per 1000 person-years in 201513Trends in overuse injury visit rates mirrored overall injury visit rates over the last 9 years with a slight increase from 660 visits per 1000 person-years in 2007 to 752 per 1000 person-years in 2015 The peak rate for overuse injuries was in 2015 at 752 visits per 1000 person-years during this timeframe
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
11
Presenter
Presentation Notes
Illustrates rates of all injury visits among male non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1000 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for males have steadily increased between 2009 and 2015 (26 increase)13Trends in overuse injury visit rates mirrored overall injury visit rates for males over the last 7 years with an 35 increase from 517 visits per 1000 person-years in 2009 to 700 visits per 1000 person-years in 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All InjuriesOveruse Injuries
Rat
es p
er 1
000
PY
Active Duty injury adjusted to remove deployed injury and deployed person-timeOveruse injuries of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
12
Presenter
Presentation Notes
Illustrates rates of all injury visits among female non-deployed Active Duty Soldiers from 2009ndash2015 13Injury visit rates have been consistently over 1400 visits per 1000 Soldiers per year throughout this 7-year period13Rates of injury visits for females have steadily increased between 2009 and 2015 (21 increase)13Trends in overuse injury visit rates for females mirrored overall injury visit rates over the last 7 years with a 25 increase from 851 visits per 1000 person-years in 2009 to 1063 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2007 2008 2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
13
Presenter
Presentation Notes
Illustrates rates of all injury visits among Army trainees from 2007ndash2015 13lsquoAll Injuriesrsquo injury visit rates decrease overall from 2842 visits per 1000 person-years in 2007 to 1643 visits per 1000 person-years in 2015 (42 decrease)13There was a small increase in injury visit rates from 2009 to 2011 but then they continued to decrease13Trainee overuse injury-visit rates have decreased 41 percent over the last 9 years from 1931 visits per 1000 person-years in 2007 to 1146 visits per 1000 person-years in 2015 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
14
Presenter
Presentation Notes
Illustrates rates of all injury visits among male Army trainees from 2009ndash2015 13lsquoAll Injuriesrsquo injury visit rates for males decreased overall from 1924 visits per 1000 person-years in 2009 to 1361 visits per 1000 person-years in 2015 (29 decrease)13There was a small increase in injury visit rates in 2011 but then rates continued to decrease13Male Trainee overuse injury-visit rates fluctuated over the last 7 years from 1256 visits per 1000 person-years in 2009 to 925 visits per 1000 person-years in 2015 (26 decrease)
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012 2013 2014 2015
All Injuries
Overuse Injuries
Rat
es p
er 1
000
PY
Overuse injury of the lower extremityData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
15
Presenter
Presentation Notes
Illustrates rates of all injury visits among female Army trainees from 2009ndash2015 13All injury visit rates for females in 2015 (3013 visits per 1000 person-years) are the lowest theyrsquove been in the last 7 years Injury visit rates rose from 2009-2011 peaking at 4729 visits per 1000 person-years and then dropping again from 2011-2015 back below 2009 rates13There was a small increase in overuse injury visit rates in 2011 but then rates continued to decrease13Female Trainee overuse injury-visit rates fluctuated over the last 7 years from 2865 visits per 1000 person-years in 2009 to 2216 visits per 1000 person-years in 2015 (23 decrease) However rates increased slightly from 2010 to 2011 peaking at a rate of 3130 visits per 1000 person-years13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 30302Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
16
31
33
33
36
54
70
93
118
188
240
00 50 100 150 200 250 300
Circulatory
Respiratory
Genitourinary
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Pregnancy
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of hospital admissions in 2015 by major diagnosis groups 13Out of 30302 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (240 percent) pregnancy-related issues (188 percent) and injury-related musculoskeletal conditions (118 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 19977Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
17
26
28
41
44
45
66
91
119
160
290
00 50 100 150 200 250 300 350
Skin amp Subcut
Nervous
Circulatory
Respiratory
Poison
Ill-defined
Msk (non-injury)
Gastrointestinal
Injury amp Msk
Mental
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of male hospital admissions in 2015 by major diagnosis groups 13Out of 19977 hospitalizations three diagnoses groups accounted for over half of all admissions mental disorders (290 percent) injury-related musculoskeletal conditions (160 percent) and gastrointestinal issues (119 percent) 1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident hospitalizations = 10325Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
18
15
18
30
31
32
37
42
49
142
552
00 100 200 300 400 500 600
Nervous
Poison
Msk (non-injury)
Ill-defined
Neoplasm
Injury amp Msk
Gastrointestinal
Genitourinary
Mental
Pregnancy
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Displays the proportion of female hospital admissions in 2015 by major diagnosis groups 13Out of 10325 hospitalizations pregnancy-related issues accounted for over half of all admissions pregnancy (552 percent)1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 2404863Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
19
29
30
31
41
65
81
87
112
170
273
00 50 100 150 200 250 300
Gastrointestinal
Genitourinary
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of outpatient visits in 2015 by major diagnosis groups 13A total of 2404863 unique outpatient visits were made by Active Duty Army personnel 655787 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 273 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (112 percent) and mental disorders (87 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 1846444Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
20
18
29
31
42
64
85
89
120
170
291
00 50 100 150 200 250 300 350
Circulatory
Gastrointestinal
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Mental
Nervous
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of male outpatient visits in 2015 by major diagnosis groups 13A total of 1846444 unique outpatient visits were made by Male Active Duty Army personnel 537118 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 291 percent of outpatient visits followed by ill-defined signs and symptoms (170 percent) nervous system conditions (120 percent) and mental disorders (89 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of incident outpatient visits = 558419Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
21
33
38
67
68
72
80
86
96
167
213
00 50 100 150 200 250
InfectParasite
Skin amp Subcut
Respiratory
Msk (non-injury)
Genitourinary
Mental
Nervous
Pregnancy
Ill-defined
Injury amp Msk
Perc
ent (
) o
f Hos
pita
lizat
ions
Presenter
Presentation Notes
Shows the proportion of female outpatient visits in 2015 by major diagnosis groups 13A total of 558419 unique outpatient visits were made by female Active Duty Army personnel 118669 were injury related 13Injuries and injury-related musculoskeletal conditions were responsible for 213 percent of outpatient visits followed by ill-defined signs and symptoms (167 percent) nervous system conditions (96 percent) and mental disorders (86 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 833Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
22
216
175
88
6246
32 28 28 23 19
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes13216 percent of unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (154 percent) motor vehicle non-traffic accidents (25 percent) military vehicle accidents (32 percent) and other land transport (02 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13175 percent of unintentional injury hospitalizations were also due to fallsjumpsnear falls 1388 percent of unintentional injury hospitalizations were due to sports The leading causes of sports-related injury hospitalizations were as follows football (17 percent of all unintentional injury hospitalizations) basketball (12 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 756Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
23
224
176
89
66
4629 28 28 21 20
0
5
10
15
20
25
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for males13224 percent of male unintentional injury hospitalizations were caused by land transport accidents Land transport-related hospitalizations were more specifically attributed to the following non-military vehicle accidents (161 percent) motor vehicle non-traffic accidents (26 percent) military vehicle accidents (33 percent) and other land transport (03 percent) While land transport-related injuries include accidents involving bicycles and railways the majority of these injuries were linked to motor vehicles 13176 percent of unintentional injury hospitalizations for males were due to fallsjumpsnear falls 1389 percent of unintentional injury hospitalizations for males were due to sports The leading causes of sports-related injury hospitalizations were as follows football (19 percent of all unintentional injury hospitalizations) basketball (13 percent) and soccer (07 percent)13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional injury hospitalizations = 77Land transport includes both traffic and nontraffic related and military and nonmilitary related incidentsData source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
24
169
143
78 78
5239
26 2613
0
5
10
15
20
Perc
ent (
) o
f All
Caus
es
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific NATO STANAG 2050 injury cause codes for females13169 percent of female unintentional injury hospitalizations were caused by fallsjumpsnear falls Land transport-related hospitalizations (143 percent) were more specifically attributed to the following non-military vehicle accidents (78 percent) motor vehicle non-traffic accidents (39 percent) and military vehicle accidents (26 percent) 13160 percent of unintentional injury hospitalizations for females were due to fallsjumpsnear falls 1378 percent of unintentional injury hospitalizations for females were due to sports The leading causes of sports-related injury hospitalizations were as follows Soccer (13 percent of all unintentional injury hospitalizations) softball (13 percent) and wrestlingjudo (13 percent)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 70079Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
174164
9687
59
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
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ent (
) o
f All
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ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
25
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes13Over half of the 70079 unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash174) or struck byagainst-related (164)
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
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ent (
) o
f All
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ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
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) o
f All
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ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 58925Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
230
172 168
9582
61
00
50
100
150
200
250
Overexertion Fall Struck byagainst
NaturalEnviron Transport CutPierce
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ent (
) o
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Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
26
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for males13Over half of the 58925 male unintentional injury hospitalizations were caused by overexertion (230 percent) falls (twists slips trips or turnsmdash172 percent) or struck byagainst an object (168 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
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ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Total number of cause-coded unintentional outpatient visits = 11154Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
231
185
142
113103
49
00
50
100
150
200
250
Overexertion Fall Struck byagainst
Transport NaturalEnviron CutPierce
Perc
ent (
) o
f All
Cau
ses
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
27
Presenter
Presentation Notes
Illustrates the distribution of the leading causes of unintentional injury hospitalizations by specific injury cause codes for females13Over half of the 11154 female unintentional injury hospitalizations were caused by overexertion (231 percent) falls (twists slips trips or turnsmdash185 percent) or struck byagainst-related injuries (142 percent) 13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region 13In 2015 there were 1823 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization 13The most common types of injury leading to hospital admission were fractures (432 percent) internal injuries (134 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (260 percent) upper extremities (208 percent) and the head and neck region (resulting in traumatic brain injury ndash 122 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (118 percent) fractures of the face (53 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (50 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Males 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for males 13In 2015 there were 1675 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for males 13The most common types of injury leading to hospital admission were fractures (431 percent) internal injuries (135 percent) and open wound (76 percent) 13Body regions most commonly leading to hospitalization were lower (256 percent) upper extremities (217 percent) and the head and neck region (resulting in traumatic brain injury ndash 125 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (115 percent) fractures of the face (56 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (51 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix1313
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Hospitalizations US Army Active Duty Females 2015
The Barell Matrix categorizes acute injuries that required hospitalization by injury type and body region for females 13In 2015 there were 148 acute and traumatic injuries (coded in the 800ndash900 ICD-9-CM code series) requiring hospitalization for females 13The most common types of injury leading to hospital admission were fractures (446 percent) internal injuries (128 percent) and sprainsstrains (68 percent) 13Body regions most commonly leading to hospitalization were lower (304 percent) the torso region (122 percent) and upper extremities (108 percent) 13Leading specific reasons for hospitalizations included fractures of the lower leg andor ankle (155 percent) internal head wounds (Type 1 traumatic brain injury (TBI)) (54 percent) and internal head wounds (Type 2 traumatic brain injury (TBI)) (47 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Outpatient Visits US Army Active Duty 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 152905 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit 13452 percent of outpatient visits were the result of sprainsstrains 149 percent were from contusionssuperficial wounds and 89 percent were due to fractures13Body regions most affected were lower extremities (393 percent) upper extremities (263 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (87 percent) and strainssprains of the shoulderupper arm (72 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 89 percent of all outpatient visits they are estimated to account for 41 percent of days of limited duty 13Dislocations account for 34 percent of all outpatient visits and are estimated to account for approximately 13 percent of days of limited duty13Sprains andor strains account for 452 percent of all outpatient visits and are estimated to account for approximately 33 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Males 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 128200 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty males 13446 percent of outpatient visits were the result of sprainsstrains 142 percent were from contusionssuperficial wounds and 93 percent were due to fractures13Body regions most affected were lower extremities (386 percent) upper extremities (274 percent) and the torso (73 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (86 percent) and strainssprains of the shoulderupper arm (75 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 93 percent of all outpatient visits they are estimated to account for 42 percent of days of limited duty 13Dislocations account for 36 percent of all outpatient visits and are estimated to account for approximately 14 percent of days of limited duty13Sprains andor strains account for 446 percent of all outpatient visits and are estimated to account for approximately 31 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention ProgramICD-9-CM coding only covers JAN-SEP 2015 Data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding
Frequency of Acute Injuries by Location and Diagnosis (BarellMatrix) Outpatient Visits US Army Active Duty Females 2015
Barell Matrix to categorize outpatient visit injuries by injury type and body region affected 13In 2015 24705 acute injuries (coded in the 800ndash900 ICD-9-CM code series) required an outpatient hospital visit for active duty females 13480 percent of outpatient visits were the result of sprainsstrains 180 percent were from contusionssuperficial wounds and 67 percent were due to fractures13Body regions most affected were lower extremities (427 percent) upper extremities (206 percent) and the torso (74 percent)13Leading specific reasons for outpatient visits included strainssprains to the lower leg andor ankle (92 percent) and strainssprains of the shoulderupper arm (58 percent)13Not all outpatient visits are less serious than those that require hospitalization Many of these injuries result in a tremendous number days of limited duty (DLD) resulting in reduced readiness and loss of manpower for the Army Estimates from clinicians and standard sports medicine texts indicate thatmdash13Fractures result in an estimated 30-180 DLD per injury13Dislocations result in an estimated 30-100 DLD per injury13Sprainsstrains result in an estimated 7-30 DLD per injury13While fractures only account for 67 percent of all outpatient visits they are estimated to account for 35 percent of days of limited duty 13Dislocations account for 22 percent of all outpatient visits and are estimated to account for approximately 10 percent of days of limited duty13Sprains andor strains account for 480 percent of all outpatient visits and are estimated to account for approximately 40 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected13In 2015 1129 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (516 percent) inflammation and pain due to overuse (249 percent) and joint derangement with neurological involvement (137 percent) 13The spineback (541 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (339 percent) and upper extremities (95 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (215 percent) joint derangement of the cervical spine (124 percent) and sprainstrainrupture of the kneelower leg (72 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty males13In 2015 964 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (519 percent) inflammation and pain due to overuse (244 percent) and joint derangement with neurological involvement (139 percent) 13The spineback (549 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (327 percent) and upper extremities (99 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (223 percent) joint derangement of the cervical spine (124 percent) and sprainsstrainsruptures of the kneelower leg (73 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Hospitalizations US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
36
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 1 20 11 0 0 0 32
497
ThoracicDorsal 0 3 4 0 0 0 7
Lumbar 5 28 5 0 0 0 38
Sacrum Coccyx 2 0 0 0 0 0 2
Spine Back Unspecified 2 1 0 0 0 0 3
Extr
emiti
es
Upper
Shoulder 7 4 0 0 0 0 11
73Upper arm Elbow 0 0 0 0 0 0 0
Forearm Wrist 0 1 0 0 0 0 1
Hand 0 0 0 0 0 0 0
Lower
Pelvis Hip Thigh 12 14 0 0 0 0 26
412Knee Lower leg 13 6 0 2 11 2 34
Ankle Foot 4 4 0 0 0 0 8
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 0 0 0 0 0 0 0
18Unspecified Site 0 1 1 1 0 0 3
Total 46 82 21 3 11 2 165 100
Total 279 497 127 18 67 12
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that required hospitalization by injury type and body region affected for active duty females13In 2015 165 hospitalizations due to injury-related musculoskeletal conditions occurred13The most common types of injury-related musculoskeletal conditions leading to hospital admission were joint derangement (497 percent) inflammation and pain due to overuse (279 percent) and joint derangement with neurological involvement (127 percent) 13The spineback (497 percent) was the body region most affected by injury-related musculoskeletal conditions followed by lower extremities (412 percent) and upper extremities (73 percent) 13The leading specific injury-related musculoskeletal conditions were joint derangements of the lumbar spine (170 percent) joint derangement of the cervical spine (121 percent) and joint derangement of the pelvishipthigh (85 percent)13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
440Knee Lower leg 88746 5388 0 1613 5278 144 101169
Ankle Foot 62014 2999 0 349 182 65 65609
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 1041 116 0 28 92 6 1283
27Unspecified Site 8289 453 1476 590 78 4 10890
Total 395773 26860 13710 2634 6502 847 446326 100
Total 887 60 31 06 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected13In 2015 446326 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (887 percent) followed by joint derangement (60 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (440 percent) was the body region most often treated on an outpatient basis followed by the spineback (338 percent) and upper extremities (195 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (199 percent) inflammation and pain (overuse) to the knee andor lower leg (199 percent) and inflammation and pain (overuse) to the ankle andor foot (139 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 06 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 60 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 887 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 84 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Males 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
38
Injury Location
DIAGNOSIS
Inflammationand Pain(Overuse)
Joint Derangement
JointDerangement
withNeurologicalInvolvement
StressFracture
SprainsStrainsRupture Dislocation Total
by body
region
BO
DY
REG
ION
Vertebral Column
Cervical 17280 1743 2760 0 0 0 21783
339
ThoracicDorsal 0 350 3985 0 0 0 4335
Lumbar 73917 8228 2840 0 0 0 84985
Sacrum Coccyx 2805 0 0 0 0 0 2805
Spine Back Unspecified 8258 484 444 41 0 0 9227
Extr
emiti
es
Upper
Shoulder 49952 3592 0 0 581 542 54667
209Upper arm Elbow 8184 111 0 2 0 5 8302
Forearm Wrist 9123 281 0 5 0 10 9419
Hand 3029 82 0 0 181 12 3304
Lower
Pelvis Hip Thigh 17110 695 0 1 48 1 17855
427Knee Lower leg 73577 4799 0 1188 4423 119 84106
Ankle Foot 50117 2486 0 253 152 57 53065
Unc
lass
ified
by S
ite Others and Unspecified
Other specifiedMultiple 737 97 0 24 88 4 950
25Unspecified Site 5886 419 1206 401 75 4 7991
Total 319975 23367 11235 1915 5548 754 362794 100
Total 882 64 31 05 15 02
Presenter
Presentation Notes
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty males13In 2015 362794 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (882 percent) followed by joint derangement (64 percent) and joint derangement with neurological involvement (31 percent)13Lower extremities (427 percent) was the body region most often treated on an outpatient basis followed by the spineback (339 percent) and upper extremities (209 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (204 percent) inflammation and pain (overuse) to the knee andor lower leg (203 percent) and inflammation and pain (overuse) to the ankle andor foot (138 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 05 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 3 percent of days of limited duty13Joint derangements account for 64 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 9 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 882 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 83 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
UNCLASSIFIED (For Public Release)US Army Public Health Center
Frequency of Injury-related Musculoskeletal Conditionsby Location and Diagnosis
Outpatient Visits US Army Active Duty Females 2015
Data source Defense Medical Surveillance System 2016 Prepared by Army Public Health Center Injury Prevention Program
Categorizes injury-related musculoskeletal conditions that resulted in an outpatient visit by injury type and body region affected for active duty females13In 2015 83532 injury-related musculoskeletal conditions outpatient visits occurred (coded in the 710-739 ICD-9-CM series)13Most musculoskeletal conditions outpatient visits involved inflammation and pain due to overuse (907 percent) followed by joint derangement (42 percent) and joint derangement with neurological involvement (30 percent)13Lower extremities (494 percent) was the body region most often treated on an outpatient basis followed by the spineback (330 percent) and upper extremities (137 percent) 13The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) to the lumbar spine (181 percent) inflammation and pain (overuse) to the anklefoot (142 percent) and inflammation and pain (overuse) to the knee andor lower leg (136 percent)13Many outpatient injury-related musculoskeletal conditions are just as serious as those that require hospitalization These injuries can result in a tremendous number of DLD resulting in loss of manpower for the Army36 13Stress fractures account for an estimated 75 DLD per injury13Joint derangements account for an estimated 21 DLD per injury13Inflammation and pain associated with overuse joint derangement with neurological involvement and sprainsstrains account for an estimated 14 DLD per injury13Stress fractures only account for 09 percent of all injury-related musculoskeletal condition outpatient visits yet they account for an estimated 4 percent of days of limited duty13Joint derangements account for 42 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 6 percent of all days of limited duty13Inflammation and pain associated with overuse accounts for 907 percent of all injury-related musculoskeletal condition outpatient visits and an estimated 86 percent of days of limited duty13For this chart data from OCT-DEC15 is NOT included due to the switch to ICD-10-CM coding and the inability to translate to this ICD-9-CM based matrix13
US Army Injury Surveillance Summary 2015
Disclaimer
Injury Pyramid US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty 2015
Relative Burden of Injuries and Diseases US Army Active Duty Males 2015
Relative Burden of Injuries and Diseases US Army Active Duty Females 2015
US Army Active Duty vs Trainee Overall Injury Visit Rates 2007-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Male 2009-2015
US Army Active Duty vs Trainee Overall Injury Visit Rates Female 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates 2007-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Active Duty Injury and Overuse Injury Visit Rates Female 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates 2007-2015
US Army Trainee Injury and Overuse Injury Visit Rates Male 2009-2015
US Army Trainee Injury and Overuse Injury Visit Rates Female 2009-2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Males 2015
Conditions Resulting in Hospitalization Top 10 ICD-9 Categories US Army Active Duty Females 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Males 2015
Injuries vs Illnesses Resulting in Outpatient Visits Top 10 ICD-9 Categories US Army Active Duty Females 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Hospitalizations by Cause US Army Active Duty Females 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Males 2015
Leading Causes of Unintentional Injury Outpatient Visits by Cause US Army Active Duty Females 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Males 2015
Frequency of Acute Injuries by Location and Diagnosis (Barell Matrix) Hospitalizations US Army Active Duty Females 2015
Slide Number 31
Slide Number 32
Slide Number 33
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisHospitalizations US Army Active Duty Females 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Males 2015
Frequency of Injury-related Musculoskeletal Conditions by Location and DiagnosisOutpatient Visits US Army Active Duty Females 2015
