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Data Café Insights: 2023 ESO Trauma Index Overview

A closer look at the 2023 ESO Trauma Index

  • Posted on March 7, 2024

The 2023 ESO Trauma Index offers a detailed analysis of current trends and benchmarks in trauma care, setting a new standard for improvement. Accompanied by the ESO Data Café Webinar series, taking place every third Thursday of the month, this report features insights from ESO Industry Experts and allows healthcare professionals to get a closer look into the data, understand its impact, and explore best practices for enhancing patient outcomes.

Designed to be a point of reference for hospitals and trauma centers alike, the Trauma Index is the largest de-identified data trauma registry program in the country. It’s built from ESO-compiled data consisting of 968,538 hospital records from 596 hospital systems that took place between January 1st to December 31st of 2022. To decide what metrics would be most helpful to include, ESO data scientists reviewed medical journals throughout the year, taking note of hot-button topics.

A retrospective look at aggregate data, the purpose of the following metrics is to both inform and ignite a conversation around best practices to help improve patient outcomes. It is not intended to be a scientific study nor comprehensive in nature, but to assist organizations like yours in better understanding where they stand against national benchmarks. 

The key metrics measured

The 2023 Trauma Index evaluated trauma care performance across several critical metrics including:

  • Whole blood and packed red blood cell usage for patients meeting Early Blood Transfusion Needs Score (EBTNS) criteria
  • Time to antibiotics for patients with open long bone fractures, including pediatrics and older adults
  • Time to surgical repair of hip fractures in older adults 
  • Systolic blood pressure (SBP) and shock index (SI) for penetrating trauma injuries 
  • Occurrence of hospital events  
  • Injury Severity Score (ISS) Summary

What were the key findings? 

A major benefit of the Trauma Index is that it not only examines this year’s performance, but also makes comparisons to the previous years’ data. All conclusions and best practices that are recommended in the Index are informed by several years of data as well as from the firsthand experience of medical professionals. Here are the key findings from the 2023 ESO Trauma Index:

  • Whole Blood Usage: There was a slight increase in whole blood usage for trauma patients, with less than 2% of those identified by the EBTNS as needing a transfusion receiving whole blood. Although effective, whole blood usage is limited because it is expensive and has a short shelf life along with other transportation and storage challenges that need to be addressed to ensure its safe administration.

  • Blood Component Timing: It was documented that 76% of patients requiring PRBCs received them within four hours of arriving at the hospital. This is a significant increase from last year’s findings, where just 46% of qualifying trauma patients received PRBC within four hours of arrival.

  • Antibiotics and Open Long Bone Fractures: The 2023 Index points out that 67.3% of patients with open long bone fractures receive antibiotics within the critical first 60 minutes of ED arrival. Patients with open long bone fractures are at increased risk for infection due to compromised disruption of skin and tissues as well as potential contamination from the external environment.

  • Surgical Repair of Hip Fractures: Demonstrating effective care prioritization, 94% of older adults with hip fractures were moved to the operating room within 24 hours. This rapid intervention reduced complications and highlights the need for maintaining and improving such protocols.

  • Penetrating Trauma: Among patients with penetrating injuries, 8% present with a systolic blood pressure less than 90mmHg, and 13% had a shock index greater than one. This highlights the critical condition of these patients upon arrival and the urgency of immediate and appropriate care to improve outcomes.

  • Hospital Events: With 8% of patient encounters involving at least one hospital event, such as unexpected ICU admissions or delirium, the Index identifies a significant area to reduce for improvement in patient safety and care quality.

  • ISS: Nearly 50% of patients with trauma-related injuries received treatment at a Level I trauma center, with an almost 95% survival rate. Patients with the most severe injuries (ISS scores greater than or equal to 25) experienced the highest mortality rates, regardless of trauma center level.


The full 2023 ESO Trauma Index can be downloaded here.

Get a breakdown of the insights and best practices from the authors of the 2023 Trauma Index 

The ESO Data Café Webinar series offers an invaluable platform for healthcare professionals to delve deeper into the 2023 ESO Trauma Index, encouraging direct interaction with its authors. These discussions aim to bridge the gap between data and practice, enabling participants to extract actionable insights tailored to their specific contexts.

Webinars are scheduled on the third Thursday of every month from 12-1 p.m. CT.

Next ESO Data Café Webinar: Whole Blood Usage for Trauma Patients 

The next  ESO Data Café Webinar is on March 21st. Join us to look behind the research on whole blood versus packed red blood cell usage for trauma patients who meet the Early Blood Transfusion Needs Score (EBTNS). Don’t forget that for every webinar you attend, you can earn nursing and registry-specific continuing education contact hours. For more details and/or to register head to the ESO Data Café registration page. 

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