Abstract

Introduction: Since the democratic changes of 1992, Albania has been grappling with a significant rise in trauma—particularly from motor vehicle accidents (MVAs), which claim three lives every two days and account for 13.7 deaths per 100,000 population annually. This trauma epidemic is the leading cause of death in people aged 15–45 and a major contributor to long-term disability, with over 2,800 Albanians living with accident-related impairments.

Objective: To evaluate patient demographics, injury patterns, and outcomes following centralization of trauma services and implementation of ATLS®-based protocols at the University Hospital of Trauma in Tirana.

Materials and Methods: We retrospectively reviewed all trauma admissions to our Emergency Department from January to December 2019. Data collected included age, sex, injury mechanism, seasonal trends, and in-hospital mortality. We compared survival rates before and after service centralization.

Results: Total admissions: 1,245 trauma patients; Sex distribution: 82.7% male, 17.3% female; Mean age: 37.1 ± 19.8 years; Age groups: 0–14 yrs (10%), 15–60 yrs (71%), > 60 yrs (19%)

Mechanisms of injury: MVAs (78%), falls from height (17%), blunt impact (5%); Seasonal peak (July–August): 215 admissions, 22 deaths (10.2% fatality rate). In-hospital mortality (annual): 8.4%; Survival improvement: 19% increase compared with the pre-centralization era

Conclusions: The centralization of trauma care into a “hub-and-spoke” model, combined with standardized Advanced Trauma Life Support (ATLS) training, has been a significant success, leading to substantial improvements in patient survival. The critical elements of our approach, including a dedicated multidisciplinary Trauma Team, evidence-based Trauma Protocols, ongoing personnel training and simulation exercises, and rapid recognition and triage of life-threatening injuries, have all contributed to this success. These findings not only support further investment in structured trauma systems but also inspire confidence in the potential for continuous professional development to reduce Albania’s trauma burden.

Keywords: trauma management; multidisciplinary team; trauma protocol, ATLS, education