ESO Releases 2023 ESO Trauma Index to Explore Key Trends and Measures Affecting Trauma Centers Across the Country

The report focused on trending injury data such as penetrating trauma, fractures, hospital events and the Injury Severity Score summary

December 13, 2023 – AUSTIN, Texas – ESO, the leading data and software company serving hospitals, emergency medical services (EMS), fire departments, state and federal agencies, today announced the findings of its 2023 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 needed and received 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 patients with penetrating trauma. Data for the Index is from January 1, 2022, through December 31, 2022.

“This year we introduced the penetrating trauma section in response to a national rise in such cases. In doing so, we analyzed patterns in systolic blood pressure (SBP) and Shock Index (SI). Generally lower SBP and higher SI scores indicate a higher risk of death,” said Garrett D. Hall. BSN, RN, CSTR, CAISS, Senior Director of Hospital and Registry Programs for ESO. These measures serve as crucial tools for triaging and prioritizing patients, allowing clinicians to identity those who require more urgent interventions.”

Hall continued, “By analyzing key trends nationwide, hospitals, including those in rural areas, can assess, adapt, transform and enhance their benchmarking practices and patient care delivery, ultimately leading to improved patient outcomes. The trauma index is fundamental in helping us understand the data and what is happening in the clinical world.”

Key Findings Include:

  • Whole Blood Usage: Less than 2% of patients meeting the EBTNS definition for blood transfusion received only whole blood, while another 3.3% received whole blood and packed red blood cells.
  • Blood Component Therapy: Of patients meeting EBTNS criteria and receiving packed red blood cells (PRBC), 76% received PRBC within four hours of arrival at the emergency department (ED) – marking a 30% increase from last year.
  • Antibiotics and Open Long Bone Fracture: Of patients with an open long bone fracture, about 67% received antibiotics within 60 minutes of hospital arrival. This excludes patients who received antibiotics prior to hospital arrival.
  • Penetrating Trauma: 8% of patients with penetrating injuries had a systolic blood pressure of less than 90mmHg, and 13% had a shock index greater than one, indicating an increased risk of death. For example, the mortality rate for patients with an SBP less than 90mmHg was 47%.
  • Time to Surgical Repair for Hip Fractures: Older adult patients requiring surgery for a hip fracture were moved from the ED to the operating room (OR) in 24 hours or less more than 94% of the time. The majority of the remaining (6%) were in the OR in less than 48 hours.
  • Hospital Events: 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.
  • Injury Severity Score (ISS): More than 50% of all patients with trauma-related injuries received treatment at a Level I 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 29% or higher.

“Our critical access hospital faced some challenges aligning administration and staff to our trauma center mission,” said Roberta Berry, Trauma Programs Manager at Gila Medical Center, a Level IV trauma center in rural New Mexico. “Introducing the Trauma Index to our program was transformative. The Index clarifies and defines the data we work with and gives us a starting benchmark to gauge our performance against others nationwide. Recognizing its potential, we’ve shared the Index with fellow trauma centers across the state so they can also use the data to foster benchmark-driven improvements in their own facilities.”

The 2023 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 nearly 600 hospitals across the United States that use ESO’s products and services and agreed to have their data used for research purposes. These data are based on 968,538 anonymized patient records between January 1 and December 31, 2022, representing a full calendar year.

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 and federal offices. 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,

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