Traumatic injury is defined as a physical injury of sudden onset and intensity that requires prompt medical and often resuscitative care to avert death or disability. Trauma can arise from blunt injury, penetrating injury, or burns and can be due to road traffic accidents, falls, work-related injury and assault or sports injury and natural disasters. As a result of urbanization and modernization, unintentional injury has come to be a major cause of visits to emergency departments around the world and so trauma has become a public health problem. ¹˒²

Trauma represents a wide spectrum of injuries, varying from soft tissue injuries to major trauma like head injury, spinal injury, major fracture, thoracic injuries, abdominal injuries, and haemorrhagic shock. All such injuries can easily cause physiological derangements and require optimal emergency management. ³

There are more than 5 million trauma-related deaths each year, which contribute to 9% of all deaths, and this is particularly high in low and middle-income countries.¹ Road traffic injuries are the main cause of trauma-related morbidity and mortality, particularly in areas where road traffic injury prevention policies are poor and there is lack of pre-hospital care and trauma care services.²,³ A young person aged 15-45 years is particularly prone to trauma injuries, and these injuries have strong socio-economic repercussions owing to loss of productivity and increased expenditure.⁴

Despite progress in trauma mortality rates in high-income settings, primarily due to improved infrastructure, a functioning trauma system, and a comprehensive emergency medical services’ system, there are still challenges in these countries in terms of delay in transport, lack of trauma care facilities, and inadequacies in prehospital care, leading to a higher fatality rate and poor outcomes in these settings.³

Tertiary care teaching hospitals are very important for the management of traumas, being referral centers for seriously ill or injured patients. These hospitals are provided with sophisticated diagnostic aids, intensive care units, and specialty teams consisting of emergency physicians, trauma surgeons, neurosurgeons, orthopaedic surgeons, anaesthesiologists, and critical care specialists. Following protocols for the management of trauma, such as the Advanced Trauma Life Support (ATLS) program, has been demonstrated to lead to better results by ensuring systematic assessment and management.⁵˒⁶

In addition to providing patient care, teaching facilities are involved in trauma-related research, development of protocols, and training of health professionals. In developing countries, these facilities are faced with challenges such as overcrowding, referrals, and resource limitations, thus pointing to the need to optimize these facilities while enhancing the peripheral trauma facilities.⁷⁻⁹

A properly functioning Emergency Medicine Department is a crucial factor in trauma care, ensuring easy triage, resuscitation, imaging, surgical, and critical care services. Prehospital care, emergency ambulance services, effective triage, availability of imaging and lab support, and operating rooms/ICUs are important determinants of trauma outcomes.¹⁰-¹⁴

RTAs are also the leading cause of trauma admissions, as established in all epidemic studies, followed by falls, assaults, and occupational injuries. The patterns of trauma admissions are region and socioeconometric-specific, with the challenge of the impact of blunt trauma and polytrauma owing to their complexity and potential for a high mortality rate.¹⁵–¹⁸

Outcome from trauma is affected by severity of injury, prehospital times, rapid activation of a trauma team, and availability of intensive care and surgical care. Prolonged times to definitive care, intensive care unit stay, use of mechanical ventilation, and development of new complications are known to be associated with adverse outcomes and mortality.¹⁹-²¹

Although progress has been made in managing trauma, morbidity and mortality rates related to trauma continue to be high in developing countries. Trauma trends, data, and information from tertiary care emergency departments can be very helpful in determining what can be done better at a particular facility. This particular research was undertaken to examine the type and outcomes of trauma cases managed at the Emergency Department of a tertiary care teaching hospital, and recommendations should be developed based on it, based on evidence, for better results.²²

This prospective observational study was conducted over a one-year period ( Jan 2024 to Dec 2024) at the Department of Emergency Medicine, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar. SKIMS is a premier tertiary care referral centre and a Level 1 Trauma Centre, providing comprehensive services from acute resuscitation to post-trauma rehabilitation for the region. The study included all trauma patients presenting to the Emergency Department (ED) during the study period. Inclusion Criteria • Patients with traumatic injuries of any mechanism (e.g., RTAs, falls, firearms, assaults). • Patients admitted for inpatient management. • Patients declared Dead on Arrival (DOA) due to trauma. Exclusion Criteria • Patients treated on an outpatient basis and discharged directly from the ED. • Patients who Left Against Medical Advice (LAMA) prior to admission. Sampling and Sample Size • Sampling Technique: Systematic random sampling was employed, enrolling every third trauma patient to minimize selection bias. • Pilot Study: A 15-day pilot study was conducted to ensure tool feasibility. • Sample Size Calculation: The sample size was determined using the single proportion formula: n = Z2 P (1-P) d2 Where: > n = Sample size Z= 1.96 (95% Confidence Level) P = Expected proportion of trauma cases (from pilot study) d = Margin of error (5%) Data Collection and Variables Data were collected using a validated, pre-tested structured proforma. Patients were followed prospectively from admission to discharge, death, or referral. Category Variables Collected Demographics Age, Gender, Education, Occupation, Urban/Rural distribution, and Socioeconomic status (BG Prasad Scale). Injury Profile Mechanism (RTA, Fall, etc.), Nature of injury, Severity, and ICD-10 Classification. Clinical Status Physiological parameters (BP, Pulse, RR) and Glasgow Coma Scale (GCS) score. Management Conservative vs. Surgical intervention, ICU admission, Mechanical ventilation, and Blood transfusions. Outcomes Mortality, Length of Hospital Stay (LOS), complications, and functional status at discharge. Statistical Analysis Data were analysed using SPSS version 26.0. • Descriptive Statistics: Continuous variables (Mean ± SD or Median with IQR) and Categorical variables (Frequencies/Percentages). • Inferential Statistics: * Chi-square ($\chi^2$) test: To compare categorical variables (e.g., injury mode vs. outcome). o Independent t-test: To compare continuous variables (e.g., hospital stay across injury types). o Multivariate Logistic Regression: To identify independent predictors of mortality. o Kaplan-Meier Analysis: To evaluate survival trends in critically injured patients. • Significance: A p-value < 0.05 was considered statistically significant. Ethical Considerations The study received approval from the Institutional Ethics Committee (IEC) of SKIMS. Informed consent was obtained from all participants or their legal guardians. Patient confidentiality was maintained through strict data anonymization.

A total of 1211 trauma patients were included in the study. The mean age of patients was 34.7 years (range: 2–85 years). The highest proportion of trauma patients belonged to the 21–30 years age group (28.6%), followed by 11–20 years (17.5%) and 31–40 years (18.8%). The most affected age group was 21–30 years, accounting for 28.6% of cases.(Table 1)

Table 1: Age distribution

A significant male predominance was observed among trauma patients, with males comprising 72.3% (n=875) of cases, while females accounted for 27.7% (n=336).(figure 1)

Figure 1: Gender distribution

Patients from rural areas accounted for 63.2% (n=765), whereas those from urban areas comprised 36.8% (n=446). (Figure 2)

Figure 2: Geographical Distribution of trauma patients

The socioeconomic status (BG Prasad Scale) distribution showed that nearly half of the trauma patients belonged to the lower class (47.7%), while 42.3% were from the middle class. The upper class comprised only 10.0% of the study population.(Figure 3)

Table 2: Occupation of Trauma Patients

Figure 3: Socioeconomic Status (BG Prasad Scale)

In this study, labourers constituted the largest affected group, accounting for 39.5% (n=478) of cases. Students comprised 23.6% (n=286) of trauma cases, Homemakers represented 17.9% (n=217) of cases. The "Others" category, comprising 19.0% (n=230), included unemployed individuals, retired persons, and miscellaneous professions that did not fit into the primary categories. (Table 2)

The majority of trauma patients in this study had received secondary education (36.2%), followed by those with primary education (25.3%). A significant portion (15.8%) of trauma patients were illiterate, while 12.2% had pursued higher secondary education, and only 10.5% had a graduate or postgraduate degree.(table 3)

Table 3: Educational Status of Trauma Patients

In our study majority of the cases presented in summer (34.0%) followed by autumn (26.3%) (figure 4)

Figure 4: Seasonal variation of trauma

Majority of the incidents took place during evening hours (35.7%) followed by afternoon (26.3%).Least number of incidents took place during night.(17.0%).(Figure 5)

Figure 5: Time of incident

Majority of the patients (42.9%) reported to hospital after 1-3 hours of the incident. Only 28.3% of the patients reported within first hour of incident.(Figure 6)

Figure 6: showing time between incident and examination

Around 57.0% of the cases presented with GCS score of >12,followed by 25.8% with GCS score of 9-12 .17.2% of the cases had a GCS score less than 8.(Table 4)

Table 4: GCS Score at Presentation

The department where the patient was admitted depended on the nature and severity of injuries. The distribution was as follows: Neurosurgery (34%), Plastic Surgery (16.3%), General Surgery (14.9%), Urology (12.5%), CVTS (12%) and Other departments (10.3%): This included orthopedics, ENT, and maxillofacial surgery cases .(Table 5)

Table 5: Primary Department of Admission

Most of the cases were referred 687(56.8%) while as only 43.2% (524 were primary). (Table 6)

Table 6: Nature of Trauma Case

The distribution of injury sites among trauma patients was analyzed to understand the most commonly affected body regions. The most frequently injured site was the head, accounting for 28.2% of cases, followed by lower extremities (18.7%) and upper extremities (14.8%). Polytrauma, where multiple body regions were affected, constituted 11.4% of cases. Chest injuries were observed in 9.9% of patients, while spinal injuries, though less common, were noted in 5.8% of cases. Abdominal trauma accounted for 6.7%, and pelvic injuries were seen in 4.4% of cases. (Table 7)

Table 7: Distribution of Injury by Site

The causes of trauma were analysed across 1211 cases. Road Traffic Accidents (RTA) were the most prevalent cause, accounting for 48.2% of cases. Falls from height were the second most common cause at 22.3%, followed by physical assault at 12.8%. Other causes, including Machine cut injuries (6.4%), firearm injuries (2.4%), and blast injuries (1.7%), were relatively less frequent. A small percentage (3.8%) of cases were brought dead. (Table 8)

Table 8: Cause of Trauma among Patients

The manner of trauma incidents was categorized into accidental, homicidal, and suicidal cases. The majority of trauma cases were accidental (88.5%), followed by homicidal injuries (7.8%), while suicidal cases accounted for 3.7%. The predominance of accidental cases highlights the need for improved road safety, workplace safety, and fall prevention strategies. Homicidal injuries were primarily due to assaults and firearm-related incidents, whereas suicidal cases were mostly due to self- inflicted injuries, including falls and firearm-related attempts. ( Figure 7)

The treatment approach for trauma patients was categorized into conservative management and surgical intervention. Among the 1211 cases analyzed, the majority (58.2%, n=705) were managed conservatively, while 41.8% (n=506) required surgical intervention. The higher  proportion  of  conservatively  managed  cases  reflects  the    predominance of mild to moderate injuries, which did not necessitate surgical intervention. However, a significant proportion still required surgical management, underscoring the severity of certain trauma cases, particularly those involving polytrauma, abdominal injuries, and fractures.(table 9)

Out of 1211 trauma patients, 41.2% (n=499) required surgical intervention. The most commonly performed procedures were neurosurgical surgeries (27.3%), followed by plastic and reconstructive surgeries (18.0%), and vascular repairs (14.6%). Orthopaedic surgeries accounted for a smaller proportion (9.4%), while laparotomies (12.0%) and thoracic

surgeries (10.2%) were also notable. (figure 8)

                                               Figure 7: Manner of Incident

Table 9 : Treatment Approach in Trauma Patients

      Figure 8: Surgical Procedures Performed

The majority of trauma patients (75.6%) were successfully treated and discharged after receiving appropriate medical or surgical management. A significant proportion (12.7%) left against medical advice (LAMA), which may be attributed to personal or financial reasons. A small percentage (0.5%) were referred to higher centers for specialized care, indicating that most cases were managed within the hospital. 4.3% of patients suffered permanent disabilities, highlighting the severe impact of trauma on long- term functional outcomes. The mortality rate in the study was 6.9%, reflecting the severity of injuries in some cases despite advanced medical interventions. (table 1)

Table 10: Outcome of treatment

In this study, the majority of patients (52.8%) were brought in by ambulance services, ensuring prompt pre-hospital care. A significant proportion (28.4%) arrived via private vehicles, reflecting the reliance on personal transport in emergency situations. 12.5% of patients used public transport, while a small fraction (5.1%) were transported by police or other emergency services. 1.2% of cases had unknown or undocumented transport modes.(figure 9)

Figure 9: Mode of Transport

A significant majority of trauma patients benefitted from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY) scheme. The study revealed that 91.5% of the patients availed benefits under the scheme, while 8.5% did not utilize it. This indicates a high awareness and accessibility of the scheme among trauma patients.

Among the less than 10% of trauma patients who did not avail the ABPMJAY benefits, the primary reasons were: Lack of Awareness (40.77%) No Ayushman Card (25.24%) – Some patients had not registered or did not possess the required documentation. Treatment Not Covered (16.5%) Certain procedures required were not included under the scheme. And Other Reasons (17.47%) Patients chose to pay out-of-pocket due to personal preferences, private insurance, or non-empaneled hospitals (Figure 10).

Figure 10: Reasons for not availing card

This prospective study provides a comprehensive overview of the demographic profile, injury patterns, management strategies, and outcomes of trauma patients presenting to the Emergency Medicine Department of SKIMS. The findings highlight trauma as a significant public health concern in the region, predominantly affecting young, economically productive individuals and largely resulting from preventable causes.

The present study demonstrates that trauma predominantly affects young adults, with the highest incidence observed in the 21–30 years age group (28.6%), followed by the 31–40 years (18.8%) and 11–20 years (17.5%) age groups. The mean age was 31.55 years (range: 2–85 years). These findings are consistent with reports from Pakistan, India, and Bangladesh, where trauma burden is highest among economically productive age groups ^(22–26). Similar regional data from Kashmir by Yatoo et al. ⁽²⁷⁾ further supports this trend. This highlights the socio-economic impact of trauma and underscores the need for preventive strategies targeting young adults, particularly road safety interventions.

A marked male predominance (72.3%) was observed, consistent with multiple national and international studies reporting male involvement ranging from 68–74% ^(22-26). Regional data from Kashmir also demonstrates a male-to-female ratio of approximately 3:1 in head trauma ^(27). This disparity is likely related to increased male exposure to high-risk activities, occupational hazards, and road traffic.

A majority of patients originated from rural areas (63.2%), mirroring findings from India, Pakistan, and Nepal ^{(22, 28–30).} Rural predominance may be attributed to poor road infrastructure, delayed access to trauma care, and limited pre-hospital services. Nearly half of the patients belonged to the lower socioeconomic class (47.7%), reinforcing the association between trauma incidence and socioeconomic vulnerability reported in previous studies ^{(23, 24, 26, 31).}

Labourers (39.5%) constituted the most affected occupational group, followed by students (23.6%) and homemakers (17.9%), a pattern consistent with prior studies ^{(27, 24, 26, 31)}. Educational status analysis revealed that trauma was more prevalent among individuals with secondary or lower education, supporting findings from Indian and Bangladeshi studies ^{(23–25, 32).} Lower education likely reflects reduced awareness of safety practices and occupational risks.

Trauma incidence peaked during summer (34.0%) and autumn (26.3%), consistent with increased outdoor, agricultural, and vehicular activity reported by other Indian studies ^{(26, 31, 33)}. Most incidents occurred during evening hours (35.7%), followed by afternoon, aligning with similar temporal distributions reported across India ^{(23, 32, 34).}

Only 28.3% of patients reached the hospital within the first hour, while 42.9% presented after 1–3 hours. This delay, observed globally ^{(35, 36),} compromises outcomes during the critical “Golden Hour”, where timely intervention significantly improves survival ^(37). These findings emphasize the need for improved emergency transport and pre-hospital care systems.

Most patients presented with GCS >12 (57.0%), indicating mild to moderate injuries, similar to reports from India and the UK (27, 26, 38). However, 17.2% had severe impairment (GCS <8), requiring intensive care. Neurosurgery (34%) was the most common admitting department, reflecting the predominance of head injuries, followed by Plastic Surgery and General Surgery—patterns consistent with prior trauma studies ^{(33, 38).}

More than half of cases were referrals (56.8%), highlighting the dependence of peripheral health facilities on tertiary centers for trauma care (82). Road traffic accidents (48.2%) were the leading cause, followed by falls from height (22.3%) and assaults (12.8%), in line with regional and international literature ^{(26, 27, 33, 39)}. The majority of injuries were accidental (88.5%), reinforcing the preventable nature of trauma through public health and safety interventions ^{(39, 40).}

The head (28.2%) was the most commonly injured region, followed by lower and upper extremities, consistent with global trauma patterns ^{(33, 41, 42)}. While 58.2% of patients were managed conservatively, 41.8% required surgical intervention. Neurosurgical procedures were most common (27.3%), followed by plastic, vascular, abdominal, orthopaedic, and thoracic surgeries, aligning with established trauma care data ^{(27, 43, 44)}

A favourable outcome was observed in 75.6% of patients who were discharged after treatment. However, 12.7% left against medical advice, possibly due to socioeconomic constraints. Permanent disability occurred in 4.3%, and the mortality rate was 6.9%, comparable to national and regional trauma mortality data ^{(23, 26, 27, 45).} These outcomes reflect both the severity of injuries and systemic challenges such as delayed presentation.

Ambulance services were utilized by 52.8% of patients, though a significant proportion relied on private or public transport, potentially delaying care ^(46–48). Encouragingly, 91.5% of patients availed benefits under ABPMJAY, significantly reducing financial burden ⁽⁴⁹⁾. Non-utilization was mainly due to lack of awareness, absence of Ayushman cards, or treatment exclusions—barriers similarly reported in other Indian studies ^{(23, 32).}

Overall, this study highlights trauma as a major yet largely preventable cause of morbidity and mortality at SKIMS, disproportionately affecting young males from rural and lower socioeconomic backgrounds. Strengthening injury prevention strategies, improving prehospital care, upgrading peripheral health facilities, and reinforcing trauma systems are essential to further improve outcomes.

1. Roudsari B, Smith GS, Adekoya N, et al. Trauma center infrastructure and outcomes of trauma care: a systematic review. Am J Surg. 2004;188(6):732-739.
2. Coles J, Lank PM, Hill N, et al. Trauma patient outcomes in rural emergency departments: a case-control study. J Trauma. 2006;61(6):1364-1370.
3. Mock CN, Forjuoh SN, Peden M, et al. Injury epidemiology in low- and middle-income countries. In: Ritchie LD, editor. Textbook of trauma surgery. 2nd ed. New York: Springer; 2007. p. 121-135.
4. Gausche-Hill M, Dulski LA, Hennes H, et al. Pediatric trauma care systems. Prehosp Emerg Care. 2007;11(3):356-363.
5. McNally S, Mahon N, et al. A comprehensive trauma network for rural emergency medical services: an infrastructural approach. Emerg Med Australas. 2007;19(6):533-539.
6. Melhado TV, Freitas Ede M, et al. Emergency trauma care infrastructure and its impact on patient outcomes. J Trauma Nurs. 2013;20(3):141-146.
7. Macintyre J, McGinnis K, et al. Trauma care outcomes: Influence of hospital infrastructure. J Trauma Acute Care Surg. 2014;76(5):1214- 1220.
8. Sasser SM, Hunt RC, Sullivent EE, et al. Guidelines for field triage of injured patients. MMWR Recomm Rep. 2009;58(RR-1):1-35.
9. Bandiera G, Stewart TC, Rowe BH, et al. Trauma outcomes in a regional hospital. J Trauma. 2008;65(5):1013-1019.
10. Nathens AB, Neff MJ, McCloskey C, et al. Trauma infrastructure and the provision of acute care: a study of level I trauma centers. J Trauma Acute Care Surg. 2008;64(3):762-768.
11. McCoy S, et al. Trauma team performance in urban emergency departments: A review of current trends. J Trauma Acute Care Surg. 2009;67(4):877-883.
12. Carrol B, Hendrickson C. The role of emergency medical infrastructure in improving trauma care. Emerg Med J. 2008;25(10):642-645.
13. Lo C, Sundararajan V, et al. Trauma center designation and patient outcomes in a rural setting: A matched cohort study. Injury. 2013;44(9):1240-1245.
14. Jha AK, et al. Trauma systems and patient survival in rural emergency departments. Health Aff (Millwood). 2009;28(4):943-951.
15. Liao H, Yeh J, et al. Impact of emergency department infrastructure on trauma patient outcomes in Taiwan. Prehosp Emerg Care. 2011;15(2):169-175.
16. Zakaria S, Shafi S, et al. Factors influencing trauma outcomes: The role of hospital infrastructure. J Trauma Acute Care Surg. 2012;73(2):431- 438.
17. Madsen TE, Reimer A, et al. Analyzing trauma patient flow in emergency departments: a review of current infrastructure practices. Ann Emerg Med. 2012;60(1):53-60.
18. Hartley D, et al. Trauma outcomes and the effectiveness of trauma systems in rural and urban areas. Ann Emerg Med. 2014;64(6):631-639.
19. McPherson JA, et al. Trauma outcomes and hospital infrastructure in emergency care. Trauma Surg Acute Care Open. 2014;2(1):e000021.
20. Browne J, Lin H, et al. Improving trauma systems through infrastructure optimization: impact on patient outcomes. Am J Surg. 2013;206(2):283-290.
21. Richards SH, O'Keefe B. The impact of trauma infrastructure on survival rates. J Trauma Acute Care Surg. 2013;75(3):490-495
22. Khan MA, Alam A, Haq I, Bashir S, Ahmad R, Wani MM, et al. Epidemiology and outcome of trauma patients in a tertiary care hospital: A prospective observational study. J Clin Trauma Emerg Med. 2024;11(1):85-92.
23. Singh R, Verma S, Kumar A, Gupta P, Sharma N, Yadav R, et al. Patterns and determinants of trauma in rural India: A cross-sectional hospital-based study. Indian J Community Med. 2024;49(1):67-74.
24. Ahmed N, Yousuf A, Bhat R, Iqbal A, Hussain M, Shafiq A, et al. Road traffic injuries and their impact on emergency healthcare services in an urban setting. Emerg Med Int. 2024;17(3):112-21.
25. Rao P, Venkatraman A, Nair K, Prakash S, Menon V, Iyer G, et al. Trauma care in India: Challenges and future directions. J Indian Med Assoc. 2024;63(2):215-30.
26. Gupta R, Sharma P, Tiwari A, Kumar N, Verma K, Mishra B, et al. The burden of trauma in tertiary care centers: A comparative analysis. J Trauma Acute Care Surg. 2024;87(4):345-52.
27. Yattoo G H, Tabish A. The profile of head injuries and traumatic brain injury deaths in Kashmir. J Trauma Manag Outcomes. 2008 Jun 21; 2(1):5.
28. Verma K, Singh M, Rajput D, Saxena R, Nair S, Masiak J, et al. Incidence and management of polytrauma cases in a level one trauma center. Trauma Surg Res Pract. 2024;14(1):76-83.
29. Mehta S, Patel V, Joshi R, Wang X, Anderson P, Sullivan T, et al. A decade of trauma management: Lessons learned from emergency department admissions. Emerg Med J. 2024;21(5):452-60.
30. Mishra B, Sharma J, Kumar S, Patel T, Joshi A, Zhang W, et al. Trauma mortality predictors: Insights from a multicenter registry. Indian J Surg. 2024;89(3):289-98.
31. Sharma N, Williams J, Brown L, Lee C, Raj K, Nair T, et al. Trauma outcomes in different hospital settings: A comparative study. World J Emerg Med. 2024;10(4):335-42.
32. Kumar A, Raj P, Nair S, Masiak J, Wang Y, Aguayo R, et al. Traumatic brain injury in India: A hospital-based cohort study. Neurol India. 2024;72(2):145-55.
33. Patel R, Rajput V, Aguayo C, Saxena H, Srinivasan S, Despandhe A, et al. The impact of trauma scoring systems on patient survival: A systematic review. Ann Emerg Med. 2024;68(3):192-204.
34. Oshi R, Patel V, Mehta S, Sharma P, Verma K, Kumar N, et al. Trauma burden in tertiary care hospitals: A retrospective study of 5,000 cases. Indian J Surg Trauma Care. 2024;19(2):125-38.
35. Wang Y, Zhang W, Anderson P, Sullivan T, Johnson K, Baker R, et al. Analysis of trauma outcomes based on injury severity scores: A multicenter study. J Trauma Acute Care Surg. 2024;31(3):77-89.
36. Anderson P, Wilson B, Smith A, Clark R, Williams J, Brown L, et al. Emergency trauma care optimization: Insights from international best practices. World J Emerg Med. 2024;16(4):210-23.
37. Sullivan T, Jang M, Wang Y, Raj P, Nair S, Masiak J, et al. Road traffic accident trends and their impact on emergency department workload. Emerg Med J India. 2024;9(1):45-58.
38. Johnson K, Baker R, Smith A, Clark R, Zhang W, Williams J, et al. Trauma system effectiveness: A decade-long evaluation of survival rates. J Trauma Res Pract. 2024;12(3):132-44.
39. Brown L, Lee J, Raj P, Nair S, Masiak J, Wang Y, et al. A review of trauma resuscitation protocols and their effectiveness. Indian J Crit Care Med. 2024;22(2):55-70.
40. Raj P, Nair S, Masiak J, Wang Y, Rajput V, Aguayo R, et al. Factors influencing trauma patient length of stay in emergency departments. J Emerg Med Res. 2024;15(3):142-57.
41. Clark R, Williams J, Brown L, Lee J, Raj P, Nair S, et al. Trends in trauma admissions and mortality: A 10-year analysis. Trauma Surg Emerg Care. 2024;20(2):112-25.
42. Zhang W, Wang Y, Johnson K, Anderson P, Rajput V, Aguayo R, et al. The impact of prehospital care on trauma patient survival: A meta- analysis. Prehosp Emerg Med J. 2024;18(3):150-64.
43. Masiak J, Wang Y, Rajput V, Aguayo R, Saxena P, Srinivasan S, et al. Hospital preparedness for mass trauma incidents: A national survey. Ann Emerg Med. 2024;21(4):215-29.
44. Wang Y, Rajput V, Aguayo R, Saxena P, Srinivasan S, Deshpande A, et al. Evaluating trauma care outcomes in resource-limited settings. World J Surg Trauma. 2024;17(2):133-48.
45. Rajput V, Aguayo R, Saxena P, Srinivasan S, Deshpande A, Chatterjee S, et al. Impact of advanced trauma life support training on patient survival. J Clin Trauma Emerg Med. 2024;13(1):75-89.
46. Aguayo R, Rajput V, Saxena H, Srinivasan S, Deshpande A, Jang M, et al. Trauma care disparities: A global perspective on injury management and outcomes. World J Surg Trauma. 2024;18(3):134-49
47. Jang M, Wilson B, Smith A, Clark R, Williams J, Brown L, et al. Predictors of trauma mortality: A large-scale registry analysis. Trauma Surg Emerg Med. 2024;23(1):55-72.
48. Lee J, Wang Y, Anderson P, Sullivan T, Zhang W, Johnson K, et al. Prehospital trauma care and its impact on survival: A multicenter observational study. J Prehosp Emerg Care. 2024;21(2):77-88.
49. Wilson B, Zhang W, Anderson P, Sullivan T, Johnson K, Baker R, et al. Evaluating trauma triage systems: Effectiveness and challenges. J Trauma Acute Care Surg. 2024;29(2):99-110.