Comprehensive meta-analysis of emergency trauma outcomes: trends, interventions, and survival rates

Abstract

Background: Trauma remains one of the leading global health challenges, with morbidity and mortality disproportionately affecting low- and middle-income countries (LMICs). While high-income nations have reported improved outcomes through the implementation of structured trauma systems, LMICs continue to bear the greatest burden of trauma-related deaths. Objective: This meta-analysis evaluates the influence of trauma centers and organized trauma systems on reducing mortality among patients with traumatic injuries, irrespective of age, region, or mechanism of injury. Methods: A meta-analysis was conducted of peer-reviewed studies published between January 2010 and December 2022, retrieved from PubMed, Scopus, and Google Scholar. Eligible studies included all age groups and trauma types, comparing outcomes between trauma centers/systems versus non-trauma settings, as well as pre- and post-implementation periods of trauma systems. Data were synthesized using relative risk (RR) and 95% confidence intervals (CIs). Results: Eighteen studies met the inclusion criteria. Group A (trauma centers/systems vs. non-trauma centers/systems) reported a reduced mortality risk associated with organized trauma care (RR = 1.14; 95% CI: 0.98–1.34; I2 = 89.37%). Group B (pre- vs. post-system implementation) showed a significant decrease in mortality following system introduction (RR = 1.87; 95% CI: 0.79–4.43; I2 = 99.55%). Funnel plot analyses indicated minimal publication bias. Conclusion: Evidence supports the role of trauma centers and systems in significantly improving survival among trauma patients. However, persistent disparities remain, especially in LMICs and rural areas. Future research should emphasize long-term patient outcomes and strategies to reduce inequities in trauma care delivery.