2026 ESO Trauma Index connects hospital and prehospital blood product data, revealing new patterns across the emergency care continuum

Fifth edition examines more than 84,000 patient encounters, introduces a new traumatic brain injury measure and shifts to patient-centric transfer time measurement

AUSTIN, Texas, May 26, 2026 (GLOBE NEWSWIRE) -- ESO Solutions, Inc. (“ESO”), a leading data services and software provider for EMS, fire departments, hospitals, and government agencies, today released the 2026 ESO Trauma Index, the annual benchmark for trauma systems built on the ESO Data Collaborative, the industry’s largest integrated emergency outcome data asset.

The fifth edition’s most significant findings included:

• Injury severity score (ISS) distribution remained consistent across mechanisms of injury, with major trauma accounting for 10% to 20% across all categories, suggesting that mechanism of injury alone is a poor predictor of overall injury burden.
• Packed red blood cells accounted for 83% of blood product administrations, consistent with national trends, while whole blood—a practice rooted in military trauma care— appeared in 13% of records, reflecting its growing adoption in civilian trauma centers.
• Severe traumatic brain injury (TBI) patients faced a mortality rate of 44%, nearly 15 times higher than mild TBI. Yet the sheer volume of mild TBI patients led to 337 deaths, reinforcing that improvement opportunities exist across the full severity spectrum.
  

The Trauma Index’s companion report, the 2026 ESO EMS Index, offers trauma systems visibility into prehospital data and a richer evidence base for improving outcomes.

"A trauma center looking at its own data sees one story. When you add prehospital intelligence, the picture shifts. When you measure that against tens of thousands of encounters from 100 facilities, you start to see where your center fits in a much larger picture," said Remle Crowe, Ph.D., NREMT, senior director of research and data enablement at ESO. "That's what the Data Collaborative is built to do. For providers at every point in the continuum, that connected view gives them the evidence base to benchmark their data and ask whether their protocols match what the broader population indicates.”

That connection can be seen in blood product administration. Blunt trauma remained the most common mechanism of injury among transfused patients at 79%, but penetrating trauma—just 7% of all encounters—accounted for 19% of blood product recipients, nearly three times its share of the registry population. In the prehospital setting, the EMS Index reported blood product administration was nearly even between blunt and penetrating at 46% and 47% respectively. The contrast suggests that penetrating trauma patients are being identified and treated aggressively in the field, while blunt trauma patients, who may present with less obvious hemorrhage, account for a larger share of transfusions once the full injury burden is assessed in the hospital setting.

More from the 2026 Trauma Index

Falls now represent nearly eight in 10 major trauma encounters among older adults, who at 45% of all encounters are the single largest age cohort in the dataset. This year’s Index also introduced a more operationally precise measurement for time to transfer, shifting the defined endpoint from discharge order time to the moment a patient physically departs the facility. The change captures the full logistical burden of the transfer process and reflects a more patient-centered view of transfer efficiency. The median order-to-departure time was 89 minutes. Among patients with open long bone fractures, 91% received antibiotics, and 74% of emergency department patients received their first dose within the 60-minute clinical target.

The ESO Trauma Index is one of three annual reports produced by the ESO Research and Performance Improvement team alongside the ESO EMS Index and ESO Fire Service Index. Access the 2026 ESO Trauma Index here. For more information on ESO, visit www.eso.com.

Methodology and Limitations
Data for the 2026 ESO Trauma Index was compiled from facilities participating in the ESO Data Collaborative for calendar year 2025. All measures are calculated exclusively from records that meet National Trauma Data Bank (NTDB) submission criteria. This approach ensures that the data underlying every metric in this Index reflects the same high-quality, standardized dataset that trauma centers submit for national benchmarking.

About ESO
ESO’s mission is to improve community health and safety outcomes through the power of data. Founded and led by emergency responders and medical professionals since 2004, ESO advances the industry by combining deep domain expertise with innovative technology, impactful research and the industry’s largest integrated emergency outcome data asset. The company delivers the world's most trusted and connected emergency ecosystem—an open, interoperable platform that unites emergency medical response, fire, hospital and government stakeholders across the full emergency continuum through real-time data exchange and embedded intelligence in frontline workflows. ESO’s solutions deliver actionable insights to decision-makers, enable smarter coordination across the emergency continuum and uphold the highest standards of data security and patient privacy. The company helps customers around the world deliver measurable improvements in clinical, operational and financial outcomes with dedicated teams in the United States, Canada, United Kingdom, Denmark, Czech Republic, India and Costa Rica. For more information, visit www.eso.com. 

Media Contact:
For ESO,
Anika Grendell
Red Fan Communications
eso@redfancommunications.com
512-662-7078

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