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However, the absence of comprehensive regional registries often limits accurate assessment. This study aimed to characterize trauma-related deaths in Biscay (Spain), a European region with an intermediately mature trauma care system, including both prehospital and in-hospital deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, population-based observational study included all trauma-related deaths in 2019 and 2022. Data were obtained from forensic autopsy reports and cross-referenced with clinical registries from the Basque Health Service. Variables analyzed were demographics, injury mechanisms, severity scores (AIS, ISS, NISS), ASA-PS classification, medico-legal intent, and physiopathological cause of death. Years of potential life lost before age 70 (YPLL70) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 313 trauma-related deaths were recorded: 151 in 2019 and 162 in 2022. Median age was 72 years (P25\u2013P75: 52\u201384), and 67% were men. Low-energy falls accounted for 41% of cases and high-energy falls for 30%. The medico-legal intent was mainly unintentional (69%), followed by suicide (29%). Traumatic brain injury (47%) and massive hemorrhage (29%) were the leading physiopathological causes. Two distinct profiles emerged: young adults sustaining high-energy trauma with severe injuries, and older adults dying after low-energy mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights a dual epidemiological pattern of trauma-related mortality in a region with an intermediately mature trauma system. Adapting trauma care pathways to address both high- and low-energy trauma, particularly in an aging population, may improve efficiency, equity, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-025-03043-x","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:32:59Z","timestamp":1768296779000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Trauma-related mortality in a European region with an intermediately mature trauma system: a comprehensive population-based analysis"],"prefix":"10.1007","volume":"52","author":[{"given":"Am\u00e9lie Marie","family":"Le Gall Travert Dit Neret","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Tamayo Medel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Bilbao Villasante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idoia","family":"Sainz-Tr\u00e1paga S\u00e1ez de Villarreal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Arrieta P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Mart\u00ednez Ruiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorka","family":"Prieto Agujeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"issue":"10440","key":"3043_CR1","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","volume":"403","author":"M Naghavi","year":"2024","unstructured":"Naghavi M, et al. 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