Patient Characteristics to Inform Military Medical Evacuation Decision-Making in Mild Isolated Head Injury.

This article focuses on identifying clinical factors associated with serious intracranial injury or early hospital discharge within 48 hours among patients with mild head injury, to inform medical evacuation decisions in austere military settings. Using data from the U.S. Department of Defense–funded Epidemiology and Outcomes of Prolonged Trauma Care (EpiC) study in South Africa, the analysis of 2,031 patients aged 18–50 with isolated mild head injury (Glasgow Coma Scale [GCS] ≥14) found that a GCS of 15 and negative or no head imaging strongly predicted discharge within 48 hours, while altered systolic blood pressure (SBP <100 or >160 mmHg), GCS of 14, and the need for life-saving interventions (LSIs) were associated with abnormal computed tomography (CT) findings and prolonged hospitalization. The study suggests these clinical indicators could aid triage and transport prioritization when advanced imaging and timely aeromedical evacuation are unavailable, though further research is needed to validate their predictive utility in military contexts. Limitations include the observational design and setting-specific factors that may affect generalizability to U.S. military populations.