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Peer-reviewedCC BYGalen medical journal

Impact of Regional Trauma System Implementation on In-Hospital Mortality in Alahsa, Saudi Arabia: A Retrospective Comparative Cohort Study : Short title: Regional Trauma System and Mortality.

  • Naif T AlQahtani1
  • Abdulelah Alanazi2
  • Mujtaba M Alkhamees3
  • Faisal T AlQahtani4
  • Ahmed S Alsaidlani1
  • Ahmed F Alharbi1
  • Omer S Alharbi5
  • Mohammed Asiri6
  • Abdulaziz Alrabiah7
7 affiliations
  1. 1Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia.
  2. 2Quality and patient safety director department, Alahsa Cluster, Ministry of Health, Saudi Arabia.
  3. 3King Fahad Hospital, Alahsa Cluster, Ministry of Health, Saudi Arabia.
  4. 4Health care assistance, Jazan region, Ministry of Defense, Saudi Arabia.
  5. 5Anesthesia Department, Armed Forces Hospital, Al-Kharj, Saudi Arabia.
  6. 6Trauma department, Trauma Path director, King Fahad Hospital, Alahsa Cluster, Ministry of Health, Saudi Arabia.
  7. 7Emergency Department, Medical City University Hospital, King Saud University, Riyadh, Saudi Arabia.
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Abstract

Trauma remains a major cause of morbidity and mortality worldwide, and road traffic injuries represent a substantial public health burden in Saudi Arabia. Structured trauma systems may improve outcomes, but their regional impact in Saudi Arabia requires further evaluation. This study assessed in-hospital mortality and injury patterns before and after trauma system implementation in Alahsa, Saudi Arabia. This retrospective comparative cohort study was conducted at King Fahad Hospital, the Level I trauma center of the Alahsa Health Cluster. Trauma patients admitted during the pre-implementation period (2017-2018) and post-implementation period (2022-2023) were included if they had an Injury Severity Score (ISS) ≥15 and hospital stay >24 hours. Demographic data, injury mechanisms, anatomical injury sites, length of stay, and in-hospital mortality were analyzed. Bivariate analyses, multivariable logistic regression, Poisson regression sensitivity analysis, and interrupted time-series analysis were performed. A total of 631 patients were included. Crude in-hospital mortality decreased from 19.0% before implementation to 16.3% after implementation, but this difference was not statistically significant (P=0.390). After adjustment for age, mechanism of injury, and ISS, the post-implementation period was not independently associated with mortality (AOR=0.97; 95% CI: 0.45-2.10; P=0.945). ISS and age were the strongest independent predictors of mortality. Significant shifts were observed in injury mechanisms and anatomical injury patterns, including reduced face and neck injuries and increased thoracic injuries. Trauma system implementation in Alahsa was associated with numerically lower crude mortality and changes in injury patterns, but mortality reduction was not statistically significant after case-mix adjustment. These findings support continued trauma registry development, pediatric trauma pathways, and subspecialty service expansion.

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Cite

BibTeXRIS
BibTeX
@article{alqahtani2026impact,
  title = {{Impact of Regional Trauma System Implementation on In-Hospital Mortality in Alahsa, Saudi Arabia: A Retrospective Comparative Cohort Study : Short title: Regional Trauma System and Mortality.}},
  author = {Naif T AlQahtani and Abdulelah Alanazi and Mujtaba M Alkhamees and Faisal T AlQahtani and Ahmed S Alsaidlani and Ahmed F Alharbi and Omer S Alharbi and Mohammed Asiri and Abdulaziz Alrabiah},
  journal = {Galen medical journal},
  year = {2026},
  month = aug,
  doi = {10.31661/gmj.v15i.4298},
  url = {https://europepmc.org/article/MED/42996519},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Impact of Regional Trauma System Implementation on In-Hospital Mortality in Alahsa, Saudi Arabia: A Retrospective Comparative Cohort Study : Short title: Regional Trauma System and Mortality.
AU  - Naif T AlQahtani
AU  - Abdulelah Alanazi
AU  - Mujtaba M Alkhamees
AU  - Faisal T AlQahtani
AU  - Ahmed S Alsaidlani
AU  - Ahmed F Alharbi
AU  - Omer S Alharbi
AU  - Mohammed Asiri
AU  - Abdulaziz Alrabiah
PY  - 2026
DA  - 2026/08/13
JO  - Galen medical journal
DO  - 10.31661/gmj.v15i.4298
UR  - https://europepmc.org/article/MED/42996519
AB  - Trauma remains a major cause of morbidity and mortality worldwide, and road traffic injuries represent a substantial public health burden in Saudi Arabia. Structured trauma systems may improve outcomes, but their regional impact in Saudi Arabia requires further evaluation. This study assessed in-hospital mortality and injury patterns before and after trauma system implementation in Alahsa, Saudi Arabia. This retrospective comparative cohort study was conducted at King Fahad Hospital, the Level I trauma center of the Alahsa Health Cluster. Trauma patients admitted during the pre-implementation period (2017-2018) and post-implementation period (2022-2023) were included if they had an Injury Severity Score (ISS) ≥15 and hospital stay >24 hours. Demographic data, injury mechanisms, anatomical injury sites, length of stay, and in-hospital mortality were analyzed. Bivariate analyses, multivariable logistic regression, Poisson regression sensitivity analysis, and interrupted time-series analysis were performed. A total of 631 patients were included. Crude in-hospital mortality decreased from 19.0% before implementation to 16.3% after implementation, but this difference was not statistically significant (P=0.390). After adjustment for age, mechanism of injury, and ISS, the post-implementation period was not independently associated with mortality (AOR=0.97; 95% CI: 0.45-2.10; P=0.945). ISS and age were the strongest independent predictors of mortality. Significant shifts were observed in injury mechanisms and anatomical injury patterns, including reduced face and neck injuries and increased thoracic injuries. Trauma system implementation in Alahsa was associated with numerically lower crude mortality and changes in injury patterns, but mortality reduction was not statistically significant after case-mix adjustment. These findings support continued trauma registry development, pediatric trauma pathways, and subspecialty service expansion.
SN  - 2588-2767
SN  - 2322-2379
ER  -