ESO Releases 2022 ESO Trauma Index to Explore Key Trends and Measures Affecting Trauma Centers Across the Country

A report focused on trending traumatic events such as hemorrhages, fractures, hospital events, and the Injury Severity Score summary

November 17, 2022 – AUSTIN, TexasESO, the leading data and software company serving emergency medical services (EMS), fire departments, hospitals, state and federal agencies, today announced the findings of its 2022 ESO Trauma Index, a report focused on key trends across hospital trauma programs nationwide. The Index is based on data from nearly 600 hospitals across the United States that are part of the ESO Data Collaborative representing one of the world’s largest deidentified trauma registry datasets. The report looks at a number of measures, including how many trauma patients received and needed whole blood based on the Early Blood Transfusion Needs Score (EBTNS); time to antibiotics for patients with open long bone fractures and time to surgery for patients with hip fractures; most frequent hospital events; and Injury Severity Score (ISS) summary. Data for the Index are from January 1, 2021, through December 31, 2021.

“This year we introduced the Early Blood Transfusion Need Score, which is one metric used to identify if a patient needs a blood transfusion,” said Garrett Hall, Senior Director of Hospital and Registry Programs for ESO. “We know that hemorrhaging is the leading cause of death for traumatic patients. If a patient received a score greater than or equal to 6, then that meant they met the needs of receiving whole blood or packed red blood cells.”

Key Findings Include:  

  1. Whole Blood Usage: Nearly 4% of those patients meeting the EBTNS definition for blood transfusion received whole blood.
  2. Red Blood Cells: Red blood cell transfusion for those patients that met the EBTNS definition (46%) received Packed Red Blood Cells (PRBC) within four hours of arrival at the.
  3. Antibiotics and Open Long Bone Fracture: Of the patients suffering from an open long bone fracture, 61% received antibiotics within 60 minutes upon arrival to the hospital. This excludes patients that received antibiotics prior to hospital arrival.
  4. Time to Surgical Repair for Hip Fractures: Geriatric patients requiring surgery for a hip fracture are moved from the emergency department (ED) to the operating room (OR) in 24 hours or less more than 95% of the time. The majority of the remaining (5%) are in the OR in less than 48 hours.
  5. Hospital Events (complications): Nearly 8% of patients had at least one hospital event or complication reported. The most reported hospital events include unplanned admission to ICU, delirium, unplanned intubation, cardiac arrest with CPR, and unplanned visit to the OR.
  6. Injury Severity Score (ISS): More than 50% of all patients with trauma-related injuries received treatment at a Level 1 trauma center, and these patients had a greater than 95% survival rate based on crude mortality. As expected, those patients with the most severe injuries with ISS scores greater than or equal to 25 experienced the highest mortality rates at 30%-plus.

“The trauma index is fundamental to measure performance,” continued Hall. “We’re in the phase of healthcare that strives for data interoperability. By comparing key trends across the nation, hospitals can mold, change, and improve the way they care for patients – improving patient outcomes. We will continue to refine and update the Trauma Index over the coming months and years to provide greater and deeper insights for the industry, with future editions including risk-adjusted benchmark reporting.”

The 2022 ESO Trauma Index can be downloaded here.


About the Index

The dataset for the ESO Trauma Index is from the ESO Data Collaborative. It is real-world, deidentified data, compiled and aggregated from more than 600 hospitals across the United States that use ESO’s products and services and agreed to have their data used for research purposes. The 2022 ESO Trauma Index looks at 884,456 deidentified patient records with hospital admission dates between January 1 – December 31, 2021.


About ESO

ESO (ESO Solutions, Inc.) is dedicated to improving community health and safety through the power of data. Since its founding in 2004, the company continues to pioneer innovative, user-friendly software to meet the changing needs of today’s EMS agencies, fire departments, hospitals, state EMS offices, and federal agencies. ESO currently serves thousands of customers throughout North America with a broad software portfolio, including the industry-leading ESO Electronic Health Record (EHR), the next generation ePCR; ESO Health Data Exchange (HDE), the first-of-its-kind healthcare interoperability platform; ESO Fire RMS, the modern fire Record Management System; ESO Patient Registry (trauma, burn and stroke registry software); and ESO State Repository. ESO is headquartered in Austin, Texas. For more information, visit


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