Abstract
Injuries remain one of the leading causes of mortality and disability worldwide, with the respective estimated economic burden exceeding 2% of GDP in many European countries. Yet, trauma systems and surveillance capacity differ greatly across countries and regions. Lack of infrastructure and the fragmentation of care result in serious gaps when it comes to comprehensive data on trauma incidence, severity, and outcomes. This critical challenge remains largely unaddressed, with current monitoring frameworks remaining heavily reliant on hospital-based registries or mortality statistics, which fail to capture crucial aspects such as prehospital care, long-term disability, rehabilitation outcomes, the social determinants of trauma, and cross-sectoral dimensions. This lack of comprehensive data makes it difficult to develop robust indicators, compare results across regions, and ultimately compromises evidence-based policymaking, and the design and deployment of effective interventions. Health systems also face major preparedness gaps. Many countries lack standardized tools and interoperable infrastructure for the real-time collection of trauma data, including essential indicators such as injury severity, time to treatment, functional recovery, and rehabilitation outcomes. These gaps reduce the capacity to deliver consistent, high-quality care and hinder the evidence base for policymaking. Strengthening surveillance, therefore, requires not only technological investment, but also improvements in workforce training, governance, and the integration of trauma data into broader health information systems. At the policy level, both the European Union (EU) and the World Health Organization (WHO) have recognized trauma care and injury prevention as public health priorities. The EU, through its Healthier Together initiative, and the WHO, through the Global Emergency and Trauma Care Initiative and the Global Status Report on Road Safety 2023, have underlined the need for stronger trauma systems, standardized indicators, and integrated rehabilitation services as part of universal health coverage. These frameworks emphasise the importance of cross-border collaboration, resilience in health systems, and integrating trauma preparedness into broader crisis planning. Despite these efforts, trauma care within the EU remains fragmented. Each EU Member State (MS) organizes its national trauma system, registries, and rehabilitation pathways, whereas no single EU strategy integrates the full continuum of trauma management from prevention and acute care to rehabilitation, reintegration, and long-term outcomes. Some EU MS, such as Denmark, the UK, and Germany, operate advanced national trauma registries, and Italy has established National Information System on Home Injuries (SINIACA) for home injuries, through national legislation (Law 493/1999), demonstrating the value of legislative frameworks for injury surveillance, whereas others lack systematic data collection altogether. The European Injury Database (IDB) represents the single most important EU-wide existing infrastructure that could effectively address this fragmentation. As the only standardized network collecting detailed injury data from emergency departments across participating EU countries, the IDB uniquely captures not just clinical outcomes but the circumstances and mechanisms of injury events -including consumer product involvement, injury intent, and environmental factors- essential intelligence for prevention. This comprehensive approach documents where, how, and why injuries occur, enabling evidence-based prevention strategies and cross-country comparisons. The absence of an EU-wide set of standardized trauma outcome indicators prevents meaningful benchmarking and policy development. Additionally, existing variations in training, staffing, and preparedness further deepen inequalities. Vulnerable populations, including children, elderly, migrants, and socioeconomically disadvantaged groups, face disproportionate injury risks and barriers to quality trauma care and rehabilitation. Trauma care remains largely resource-dependent and focused on tackling day-to-day caseload, with many systems ill-prepared to respond effectively to mass casualty events or climate-related disasters. What is currently missing is a coordinated pan-European Action Plan on Trauma Systems. Such a plan could establish minimum standards across Europe, allow for the integration of primary prevention strategies based on injury surveillance data, the harmonisation of surveillance and outcome indicators. Such a plan would allow resource allocation and destrengthen and expand existing infrastructures like the IDB, foster cross-border collaboration for large-scale emergencies, and, ultimately, ensure that rehabilitation and patient-reported outcomes are systematically integrated into system evaluation. The upcoming workshop will bring together leading experts in epidemiology, trauma care, and patient advocacy to review good practices, identify gaps, and propose pathways for scaling successful models. The discussion will highlight how harmonized surveillance systems, patient-centered approaches, and continuous audit cycles can improve trauma care. Lessons will be drawn from international and European experiences, including the Australian context as a global best practice of standardized outcome indicators and patient-reported data integration, the IDB as a model of harmonized surveillance, and the Danish National Trauma Registry as a case study in quality assurance and integration of prehospital and hospital data. These examples will illustrate how robust data systems lead to measurable improvements in outcomes and how equity considerations and patient advocacy can ensure that trauma reforms remain aligned with survivors’ real-life needs. By bridging the EU’s Healthier Together initiative to the WHO’s global frameworks, the session will cohesively merge European policy directions with international best practices. It will explore how EU-level initiatives and funding mechanisms, including Horizon Europe, can be aligned with WHO’s calls for standardized indicators, workforce preparedness, and rehabilitation integration. This alignment will help to define common priorities such as harmonized surveillance, continuity of care, and the integration of equity and rehabilitation into all aspects of trauma management.The discussion will emphasize how surveillance data must translate into concrete prevention policies and interventions, with regular feedback loops to assess impact and refine strategies. The session will conclude with a call to action for a unified European roadmap on trauma surveillance and system strengthening, fully aligned with WHO guidance. Such a roadmap would provide a cohesive framework for building trauma systems that are integrated, resilient, and patient-centered, capable of saving lives, reducing disability, addressing the needs of survivors and safeguarding public health across Europe.