Standardized reporting of U.S. military injuries.

PROBLEM: The epidemiology of injuries in U.S. military settings has historically relied on the use of medical diagnosis codes in the military's medical system of records. With significant changes introduced by an updated international medical coding scheme from ICD-9-CM to ICD-10-CM, a new military injury surveillance approach was necessary. The Taxonomy of Injuries was developed in 2016 and includes an injury definition, medical diagnosis codes aligned with the definition, and categorization of injury diagnosis codes by energy transfer type, injury type, and injured body region. This paper provides standardized reporting of injuries for all U.S. military services conducted for the Defense Safety Oversight Council (DSOC) Military Injuries Working Group (MIWG). METHOD: The Taxonomy methodology was applied to calendar year (CY) 2021 medical data obtained from the Military Health System Data Repository for all U.S. military services to analyze the distribution of injuries. Results were summarized by Taxonomy categories and presented in the standard Taxonomy reporting wire diagram format. RESULTS: There were approximately 1.5 million incident unique injuries among U.S. military service members in 2021. The majority of injuries (75%) were cumulative micro-traumatic often due to overuse, and 69% were categorized as musculoskeletal tissue damage. Leading injured body regions were lower extremities (37%), spine and back (28%), and upper extremities (21%). DISCUSSION: As a result of DSOC MIWG efforts, the epidemiological surveillance of injuries can be uniformly presented across all U.S. military services through use of the Taxonomy. Results for 2021 are consistent with previous analyses and reflect injuries experienced in a young, physically active population. Application of the Taxonomy through annual updates allows consistent comparisons across years and populations. PRACTICAL APPLICATIONS: The Taxonomy continues to gain recognition nationally and internationally for its comprehensive capture of injuries and its easily replicated standardized methodology for injury surveillance reporting.