KHAKREZ DISTRICT, Afghanistan  Intensified fighting and a larger troop presence in Afghanistan in 2010 led to the highest American combat casualties yet in the war, as the number of troops wounded by bullets, shrapnel and bombs approached that of the bloodiest periods of the war in Iraq.

But the available data points to advances in the treatment of the fallen, as the rate at which wounded soldiers who died reached a wartime low.

More than 430 American service members died from hostile action in Afghanistan last year through Dec. 21, according to official data released by the Pentagon last week at the request of The New York Times.

This was a small fraction of those struck. Nearly 5,500 American troops were wounded in action  more than double the total of 2,415 in 2009, and almost six times the number wounded in 2008.