Neurology in Operation Iraqi Freedom: Risk factors for referral, clinical presentations and incidence of disease

Six hundred and sixteen patients were referred for consultation to the author who served as the neurologist on the 252nd Neurosurgical Team in Kuwait in support of Operation Iraqi Freedom between April and October, 2003. Demographic and military data were collected. The cohort of neurologic patients showed significant differences from the total population of the United States Army contemporarily deployed to Operation Iraqi Freedom. Versus the deployed personnel, the neurologic cohort was older in age (p < 0.001), had a greater percentage of females (p < 0.00001), had an excessive representation for the military rank of sergeant (p < 0.00001), with a deficit of other ranks (junior enlisted and officers), and were more likely to soldiers from the Reserves (p < 0.00001) and National Guard (p = 0.0021) than from the Regular Army. Seven categories of chief complaints and ten categories of diagnoses constituted some 80% of patients. The incidence of neurologic disease was calculated to be 634 per 100,000 people/year. This information provides valuable information for military neurologists concerning their anticipated duties in future deployments and for non-neurologists by focusing their skills in the evaluation of common neurologic presentations, yet further research is needed to optimize the neurologist's role in a field environment.