Global Trauma Personas - Understanding the Case Mix of Patients Undergoing a Trauma Laparotomy Worldwide

Global Trauma Personas Understanding the case mix of patients undergoing a trauma laparotomy worldwide October 2025 Summary of the Persona set Persona Cluster size Age Mechanism of injury Method of transport Severity of injury Khalid 25% 28 Penetrating Private vehicle Moderate Juan 15% 25 Blunt Private vehicle Moderate Obi 8% 28 Penetrating Private vehicle Severe Bekena 12% 28 Penetrating Private vehicle Moderate Somchai 4% 44 Blunt Air ambulance Severe André 5% 58 Blunt Ambulance Severe Fayza 7% 23 Blunt Private vehicle Moderate Silvia 9% 52 Penetrating Ambulance Moderate Elif 8% 58 Blunt Ambulance Moderate Aleksander 7% 26 Blunt Ambulance Critical 2 Overview The use of personas enables a deeper understanding and appreciation of the diverse patient population involved in trauma system design and development. The personas presented here reflect common presentation patterns among patients who undergo trauma laparotomies across the world and are intended to support a design process that fully represents the spectrum of trauma care. Using four key variables - Age, Mechanism of Injury, Method of Transport, and Injury Severity Score - we identified ten distinct patient clusters through k-means clustering from the GOALTrauma dataset (goaltrauma.org). These variables were selected from a broader set for their ability to generate clearly defined and well-separated clusters. Although the clusters do not encompass the full range of population variation within each setting, their use is encouraged when planning trauma process and services within a hospital or region. Detailed narratives for each persona are provided below. For more information about the persona dataset and the methodology behind its construction, please contact our team at [email protected]. 3 4 Persona 1: Khalid Age: 28 Mechanism of injury: Penetrating Method of transport: Private vehicle Severity of injury: Moderate Background Khalid, 28, has just left a restaurant after dinner with friends and was walking home through a quiet street when suddenly a man on a moped approaches and rides next to him. Following a brief confrontation, the assailant shoots Khalid with a single shot in the abdomen and flees the scene with his wallet. Khalid collapses to the ground and lays there for some time before a passerby discovers him and calls for emergency help. A passerby calls their friend, who puts Khalid in the back of a car and drives him to the city’s main hospital. Arrival He arrives at the hospital around four hours after the initial injury. On arrival, he is awake and alert, however his observations show he is tachycardic, and his blood test show a low haemoglobin level. Initial investigations show a suspected isolated injury to the left kidney that requires urgent operative intervention. 5 Persona 2: Juan Background Juan, 25, was riding his moped through a suburban street when a dog suddenly darted into his path. In an attempt to avoid it, he swerved abruptly and collided with a bollard. The impact drove the handlebar straight into his abdomen, knocking him off the vehicle and onto the ground. He remained conscious, clutching his stomach and groaning in pain. A passerby who witnessed the crash quickly flags down a taxi and helps Juan into the back, directing it to the nearest health centre. Arrival At the nearby health centre, Juan is assessed, vital signs are stable, they place a peripheral cannula line and start intravenous fluids, however his abdomen is tender and distended. Staff there conclude he may have an internal organ injury, but they do not have the expertise or capability to manage him, so arrange for an ambulance to transfer him to the city’s main hospital. On arrival at this hospital, around 2 hours after the injury, his observations remain stable and his blood tests are unremarkable. However, he is in significant pain and diffusely tender in his abdomen on examination; the A&E doctor performs a FAST (Focused assessment with sonography for trauma) examination that shows likely free fluid in the abdomen and a decision is made that he requires an emergency operation. Age: 25 Mechanism of injury: Blunt Method of transport: Private vehicle Severity of injury: Moderate 6 Persona 3: Obi Age: 28 Mechanism of injury: Penetrating Method of transport: Private vehicle Severity of injury: Severe Background Obi, 28, was spending time with friends near a market stall when gunmen on mopeds suddenly arrived and opened fire. He was hit multiple times in the chest and abdomen. As people fled in panic, Obi collapsed to the ground. His brother, unharmed, stayed with him and quickly arranged for a private vehicle to take him to the main hospital. On route to hospital, they are met with heavy city traffic and are significantly delayed. Arrival On arrival to the hospital, around 4 hours since the injury, his observations are stable and Obi is awake and alert. A peripheral cannula is placed and intravenous fluids are started. The initial investigations show a small pneumothorax, deep laceration to his forearm, and a suspected small bowel injury that requires surgical intervention. 7 Persona 4: Bekena Background Bekena, 28, was working on his farm when armed robbers stormed the property, wielding machetes in an attempt to steal his cattle. During the attack, he sustained multiple superficial cuts to both arms and a deeper stab wound to the abdomen. Despite the chaos and once the robbers had fled, a friend managed to get him into the back of a car and drove him directly to the city’s main hospital. Arrival He arrives at the hospital approximately 2 hours after the incident. Bekena’s observations are stable and initial blood tests show a haemoglobin within normal range. However, on clinical assessment, given the size of the abdominal wound and the mechanism of injury, there is sufficient concern that there is a breach of the peritoneum and exploration of this is required in the operating theatre. Age: 28 Mechanism of injury: Penetrating Method of transport: Private vehicle Severity of injury: Moderate 8 Persona 5: Somchai Background Somchai, 44, was crossing a busy urban road on his way to work when he was struck by a fast-moving car. The collision threw him to the ground, where he lay motionless as nearby pedestrians rushed to help. Given the severity of the impact and the concern for polytrauma, emergency services dispatched an air ambulance to expedite his transfer to hospital. Arrival On arrival to hospital, his observations show a stable blood pressure with a persistent tachycardia. He has already received tranexamic acid and blood products en route in the air ambulance. On assessment by the A&E team, he has suspected severe injuries to his head, chest, and abdomen, with both the lactate and base excess very high. Initial investigations suggest a potential splenic laceration that warrants operative intervention. Age: 44 Mechanism of injury: Blunt Method of transport: Air ambulance Severity of injury: Severe 9 Persona 6: André Background André, 58, was heading home from work on his moped during early evening traffic. As he approached a junction, the car behind him attempted a risky overtake, forcing André to swerve sharply into the opposite lane, where he collided head-on with an oncoming vehicle. He was thrown off his moped and hit the ground with force, remaining motionless at the roadside. The driver of the oncoming car exited the vehicle and immediately called emergency services. An ambulance arrives after 20 minutes, finding André with a low blood pressure and having difficulty in breathing, with his oxygen saturation levels at 88%. They place a peripheral cannula and start intravenous fluids, and take him into the ambulance. Arrival He is taken to the city’s major hospital, arriving around 2 hours after his injury. On primary examination, his oxygen levels and blood pressure remain low, so he is intubated in the A&E department and 2 units of whole blood are ordered. He has evidence of a severe trauma to the head, a visibly injured right upper limb, and generalised abdominal tenderness, with assessment suggesting severe visceral injury, presumed to be both a liver laceration and splenic laceration. Age: 58 Mechanism of injury: Blunt Method of transport: Ambulance Severity of injury: Severe