{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:13:38Z","timestamp":1766967218140,"version":"3.48.0"},"reference-count":14,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Continuous trauma-system monitoring is limited by the lack of scalable, low-cost tools. The Pavia Trauma Management Epidemiology (PaTraME) project uses routinely collected ICD-9-CM discharge data (SDO) and the Trauma Mortality Probability Model (TMPM) to derive Injury Severity Score (XISS) and probability of death (TMPM-POD), creating a cost-free surveillance framework for regional trauma networks. Methods: We conducted a retrospective study of all major-trauma admissions (XISS &gt; 15) in Pavia Province from 2014 to 2021. Anonymized SDO records were linked with emergency department flows and mortality registries. XISS and TMPM-POD were computed for each case. Case volumes, severity distributions, hub-centralization, and mortality (in-hospital, 30-day, and 180-day) were analyzed using trend and regression models (p &lt; 0.05). Conclusions: We identified 1959 major-trauma admissions. Volumes increased up to 2019, dropped during the COVID-19 pandemic, and partially recovered in 2021 (p &lt; 0.001). Overall, 61.5% of patients were admitted to hub centers, with an upward trend (p &lt; 0.001). Hubs treated more severe trauma (median XISS 17 vs. 16; TMPM-POD 0.06 vs. 0.05, both p &lt; 0.001). In-hospital mortality remained stable (8.2\u201311.4%, p = 0.828). TMPM-POD showed strong agreement with observed in-hospital mortality (Lin\u2019s concordance correlation coefficient 0.81), though calibration worsened at higher risk levels. PaTraME confirms TMPM-POD as a valid mortality predictor and demonstrates a reproducible administrative-data framework for trauma surveillance. Rising hub admissions and stable mortality despite increasing complexity suggest improved system performance. Stratification of XISS and TMPM-POD between hub and spoke centers highlights peripheral hospitals managing disproportionately severe cases, informing targeted resource allocation and supporting quality improvement via automated dashboards.<\/jats:p>","DOI":"10.3390\/medsci14010013","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T23:54:36Z","timestamp":1766966076000},"page":"13","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of an ICD-9-CM-Based Monitoring Tool for Regional Trauma Systems: The PaTraME Study in Pavia Province, Italy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6227-9276","authenticated-orcid":false,"given":"Paola","family":"Fugazzola","sequence":"first","affiliation":[{"name":"General Surgery, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-7287","authenticated-orcid":false,"given":"Leandro","family":"Gentile","sequence":"additional","affiliation":[{"name":"Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5822-3712","authenticated-orcid":false,"given":"Francesco","family":"Chiarolanza","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Perotti","sequence":"additional","affiliation":[{"name":"UOC (Unit\u00e0 Operativa Complessa) Osservatorio Epidemiologico per il Governo della Domanda, ATS (Agenzia di Tutela della Salute) Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Alessiani","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"},{"name":"UOC (Unit\u00e0 Operativa Complessa) Chirurgia Generale, Ospedale Unificato di Broni-Stradella, ASST (Azienda Socio Sanitaria Territoneiale) Pavia, 2049 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Capra Marzani","sequence":"additional","affiliation":[{"name":"UOC (Unit\u00e0 Operativa Complessa) Anestesia e Rianimazione 1, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Cobianchi","sequence":"additional","affiliation":[{"name":"General Surgery, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Frassini","sequence":"additional","affiliation":[{"name":"General Surgery, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0912-5726","authenticated-orcid":false,"given":"Federico Alberto","family":"Grassi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"},{"name":"UOC (Unit\u00e0 Operativa Complessa) Ortopedia e Traumatologia, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0314-8548","authenticated-orcid":false,"given":"Catherine","family":"Klersy","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology & Research Design (BERD) Unit, Research Department Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Muzzi","sequence":"additional","affiliation":[{"name":"Direzione Sanitaria, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Palo","sequence":"additional","affiliation":[{"name":"UOSD (Unit\u00e0 Operativa Semplice di Dipartimento) AAT (Articolazioni Territoriali Agenzia) di Pavia, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Perlini","sequence":"additional","affiliation":[{"name":"UOC (Unit\u00e0 Operativa Complessa) Medicina di Urgenza, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Medicina Interna e Terapia Medica, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Raimondi","sequence":"additional","affiliation":[{"name":"UOC (Unit\u00e0 Operativa Complessa) Anestesia e Rianimazione Oltrep\u00f2, ASST (Azienda Socio Sanitaria Territoneiale) Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6427-0307","authenticated-orcid":false,"given":"Luca","family":"Ansaloni","sequence":"additional","affiliation":[{"name":"General Surgery, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the PaTraME Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,27]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022). 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