Summary

Analysis and 6-month mortality of patients attended by prehospital emergency services with severe hemorrhage in a Spanish province

Rubén Viejo-Moreno^1-3, Elena Moratilla-López^1,2, Raquel Grado-Sanz^1,2 Sandra Castro-Correro^1,2, Antonio Cid-Dorribo^1,2, Waleska Chas-Brami³, Enrique Galván-Muñoz¹

Affiliation of the authors

¹Gerencia de Urgencias, Emergencias y Transporte Sanitario (GUETS) – Servicio de salud de Castilla la Mancha (SESCAM), Spain. ²Grupo de trabajo y comisión clínica de trauma. GUETS – SESCAM, Spain. ³Unidad de Cuidados Intensivos, Hospital Universitario de Guadalajara, Spain.

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Viejo-Moreno R, Moratilla-López E, Grado-Sanz R, Castro-Correro S, Cid-Dorribo A, Chas-Brami W, Galván-Muñoz E. Analysis and 6-month mortality of patients attended by prehospital emergency services with severe hemorrhage in a Spanish province. Rev Esp Urg Emerg. 2026;5:24–9

Summary

INTRODUCTION. Hemorrhage continues to be a major cause of mortality in both medical and traumatic conditions. Early identification and optimal prehospital treatment are essential to improve outcomes. This study aimed to analyze the clinical course and 6-month mortality in patients with severe hemorrhage (SH) treated by prehospital emergency services in a Spanish province.
MATERIAL AND METHODS. We conducted a retrospective observational study from January 2020 through December 2024, including patients treated by advanced prehospital emergency units for medical or trauma-related SH. Severe hemorrhage was defined as requiring at least 3 units of packed red blood cells within the first 6 hours of hospital care. Demographic variables, hemorrhage source, prehospital and hospital treatments, length of stay, and 6-month mortality were analyzed as well.
RESULTS. During the study period, a total of 145 patients with SH who received hospital transfusion after prehospital emergency care were identified; 71 % were trauma-related and 29 % medical. The overall 6-month mortality rate was 26.2 %, with no significant differences across groups (trauma 32 %, medical 25 %). Factors associated with higher mortality included shock index (SI), lower Glasgow Coma Scale (GCS) scores, need for prehospital orotracheal intubation, longer response time, elevated lactate levels, and longer time to first hospital transfusion.
CONCLUSIONS. SH in our setting is associated with high mortality. Future studies should assess the impact of implementing pointof- care tools for early stratification and expanding the availability of blood components in advanced prehospital units to improve patient outcomes.