Trauma-Related Mortality in a European Region with an Intermediately Mature Trauma System: A Comprehensive Population-Based Analysis

Trauma-Related Mortality in a European Region with an Intermediately Mature Trauma System: A Comprehensive Population-Based Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Trauma-Related Mortality in a European Region with an Intermediately Mature Trauma System: A Comprehensive Population-Based Analysis Amélie Marie Le Gall Travert Dit Neret, Gorka Prieto Agujeta, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7722456/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 13 Jan, 2026 Read the published version in European Journal of Trauma and Emergency Surgery → Version 1 posted 24 You are reading this latest preprint version Abstract Understanding the epidemiology and caseload of trauma is a necessary first step in designing effective continuous quality improvement strategies. However, obtaining precise statistics is challenging in absence of a specific and comprehensive registry. This retrospective observational study analyzed all trauma-related deaths in Biscay (Spain) in 2019 and 2022, a region with an intermediately mature trauma system. The objective was to provide a comprehensive characterization of trauma mortality, including prehospital deaths, to guide improvements in trauma care. A total of 313 deaths were recorded. The mean age was 67 years, with trauma accounting for 33% of all deaths among men aged 20–29. The most frequent injury mechanisms were low-energy falls (40.9%), predominantly among the elderly, and high-energy falls (29.7%). Non-penetrating injuries accounted for 94.2% of cases. Medico-legal etiology was predominantly accidental (69%). Suicides represented 28.8% of deaths, 42.2% of which occurred among individuals aged 15–64. Traumatic brain injury and massive hemorrhage were the leading physiopathological causes of death. Most victims had a single anatomical region with severe injury. According to ISS values, 17.6% of deaths were classified as potentially preventable and 49.8% as possibly preventable. The findings reveal a dual profile of trauma-related mortality: on one hand, young adults affected by high-energy trauma with severe injuries; and on the other, older adults, in whom low-energy trauma with less severe injuries predominates but has a major impact due to frailty. This analysis highlights an opportunity to optimize the trauma care pathway and adapt it to the challenges posed by demographic change. Trauma-related mortality trauma system causes of trauma deaths Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 13 Jan, 2026 Read the published version in European Journal of Trauma and Emergency Surgery → Version 1 posted Editorial decision: Revision requested 25 Oct, 2025 Reviews received at journal 24 Oct, 2025 Reviews received at journal 20 Oct, 2025 Reviews received at journal 20 Oct, 2025 Reviews received at journal 18 Oct, 2025 Reviews received at journal 18 Oct, 2025 Reviews received at journal 17 Oct, 2025 Reviews received at journal 14 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviewers agreed at journal 12 Oct, 2025 Reviews received at journal 09 Oct, 2025 Reviewers agreed at journal 08 Oct, 2025 Reviews received at journal 07 Oct, 2025 Reviewers agreed at journal 07 Oct, 2025 Reviewers agreed at journal 07 Oct, 2025 Reviewers agreed at journal 07 Oct, 2025 Reviewers agreed at journal 06 Oct, 2025 Reviewers agreed at journal 05 Oct, 2025 Reviewers agreed at journal 05 Oct, 2025 Reviewers agreed at journal 05 Oct, 2025 Reviewers invited by journal 05 Oct, 2025 Editor assigned by journal 05 Oct, 2025 Submission checks completed at journal 27 Sep, 2025 First submitted to journal 26 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7722456","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":530020526,"identity":"1f3edc3c-7fd3-47b8-9369-429acc448cee","order_by":0,"name":"Amélie Marie Le Gall Travert Dit 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