Most trauma deaths happen before hospital arrival, highlighting urgent needs in trauma care.

• Of 3,089 adult trauma patients, 497 (16.1%) died; 77.1% died pre-hospital, typically within 12 minutes of injury.
• Hemorrhage and traumatic brain injury accounted for 81.9% of deaths, with 96.2% of hemorrhage deaths occurring pre-hospital.

Surgeons should focus on improving pre-hospital interventions to enhance survival odds, emphasizing life-saving actions before patients reach the hospital.

• 95.1% of penetrating trauma fatalities also occurred pre-hospital, signifying a critical area for intervention.