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. 2025 Jun 23;6(4):100211.
doi: 10.1016/j.acepjo.2025.100211. eCollection 2025 Aug.

Battlefield Neck Injuries: Contemporary Insights From the Israeli National Trauma Registry

Nir Tsur  1   2 , Dean Dudkiewicz  1   2 , Tomer Talmy  1   3   4 , Irina Radomislensky  1   5 , Adi Givon  5 , Eldad Katorza  5   6   7 ; Israel Trauma Group; Gilad Twig  5   7 , Mor Rittblat  1   3   8 , Shahar Shapira  5   7
Collaborators, Affiliations

Battlefield Neck Injuries: Contemporary Insights From the Israeli National Trauma Registry

Nir Tsur et al. J Am Coll Emerg Physicians Open. .

Abstract

Objectives: Neck injuries in warfare are critical due to the concentration of vital structures within a relatively unprotected anatomical region. This study aims to provide a comprehensive analysis of the epidemiology, severity, and outcomes of neck injuries during Military operations under "Operation Swords of War," leveraging data from the Israeli National Trauma Registry.

Methods: Data were retrospectively collected for casualties from October 7, 2023, through December 31, 2023. Injury characteristics, time to surgical exploration, and in-hospital outcomes were analyzed.

Results: A total of 1815 trauma casualties were recorded, with 147 (8.1%) suffering from neck injuries. The majority of these injuries were due to penetrating trauma (89.8%), with a significant number leading to surgical exploration (45.0%). The study highlighted the extensive use of resources for managing these severe injuries, including operating rooms and intensive care units.

Conclusion: The findings underscore the high prevalence and severity of neck injuries in military conflicts and the critical need for rapid assessment and intervention. Comparisons with previous conflicts suggest an improvement in survival rates due to enhanced medical response and triage efficiency. In conclusion, neck injuries remain a significant concern in combat settings, necessitating specialized trauma care and rapid intervention strategies. The results from this study provide vital insights that can help improve trauma care protocols and outcomes in future conflicts.

Keywords: ICU admission and outcomes; combat-related neck trauma; military conflict epidemiology; penetrating injuries; rapid intervention strategies; surgical exploration; trauma registry analysis.

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Conflict of interest statement

All authors have affirmed they have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Divided percentage of time to neck exploration versus other procedures. The graph displays the divided percentage of cases explored over time, segmented into the 2 intervals: 0-3.9 hours, and 4+ hours. Each sky-blue bar represents the percent of explorations completed at the interval.
Figure 2
Figure 2
Emergency referral and hospitalization distribution in patients with laryngotracheal injuries. The graph displays the comparative distribution of clinical outcomes between patients with vascular injuries and those without vascular injuries. Each blue bar represents the percentage of patients for each variable, illustrating the referral and hospitalization distribution
Figure 3
Figure 3
Emergency referral and hospitalization distribution in patients with vascular injury. The graph displays the comparative distribution of clinical outcomes between patients with laryngotracheal injuries and those without laryngotracheal injuries. Each blue bar represents the percentage of patients for each variable, illustrating the referral and hospitalization distribution.
See this image and copyright information in PMC

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