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Investigation of Trauma Cases Presented to the In-Event Health Care Services in Mass Gatherings: A Systematic Review.

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Τίτλος: Investigation of Trauma Cases Presented to the In-Event Health Care Services in Mass Gatherings: A Systematic Review.
Συγγραφείς: Ekrem Çebi G; Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkey., Ertan A; Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkey; Department of Property Protection and Security, Vocational School, Biruni University, Istanbul, Turkey. Electronic address: aertan@biruni.edu.tr., Ege Zilan D; Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkey., Koçak H; Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey., Kınık K; Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey., Bek Yağmur Ö; Istanbul Provincial Health Directorate, Turkish Ministry of Health, Istanbul, Turkey., Çalışkan C; Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey.
Πηγή: The Journal of emergency medicine [J Emerg Med] 2026 Aug; Vol. 87, pp. 31-50. Date of Electronic Publication: 2026 May 07.
Τύπος έκδοσης: Journal Article; Systematic Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 8412174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0736-4679 (Print) Linking ISSN: 07364679 NLM ISO Abbreviation: J Emerg Med Subsets: MEDLINE
Imprint Name(s): Publication: <2010>- : New York : Elsevier
Original Publication: New York : Pergamon Press, c1983-
Ιατρικοί όροι (MeSH): Wounds and Injuries*/epidemiology , Mass Casualty Incidents*/statistics & numerical data , Mass Behavior*, Emergency Medical Services/statistics & numerical data ; Humans
Περίληψη: Background: Mass gatherings (MGs) are associated with increased healthcare demand and may pose a risk for mass casualty incidents if medical services are not adequately planned. Trauma presentations constitute an important component of medical encounters during MGs; however, evidence regarding trauma patterns and preparedness requirements remains fragmented.
Objective: The primary aim of this study was to examine rates of trauma-related presentations to in-event health care areas during MGs. Secondary aims were to identify trauma patterns across different event types, support planning of in-event health services and develop a practical checklist to assist trauma preparedness and response planning.
Method: Following PRISMA guidelines, a systematic search was conducted across PubMed, Web of Science, and Scopus databases for studies published between 2015 and 2025. Articles were screened based on the PICOS framework, focusing on observational studies of MG participants exposed to trauma. Inclusion required the reporting of in-event healthcare data, while studies solely using hospital-based records or lacking trauma-specific metrics were excluded. Data were extracted using a standardized form to identify event characteristics, patient presentation rate (PPR), and transport to hospital rates (TTHR). The primary outcome was the incidence of trauma, while secondary outcomes included the identification of trauma subtypes (e.g., musculoskeletal, soft tissue).
Results: The initial search yielded 382 articles. After removal of duplicates and exclusions, 18 relevant studies were included in the final synthesis. The proportion of trauma-related visits relative to all patients treated at in-event medical stations ranged from 11.7 to 81.7%. The highest trauma rate was reported at the European Youth Olympic Winter Festival (81.7%), whereas the Guadalajara International Book Fair reported the lowest (11.7%). Soft tissue injuries (13-42.3%) were the most prevalent across music and sporting events, followed by musculoskeletal injuries (3-35.7%). Events involving mosh pit behavior showed a distinct clustering of head and facial injuries (65%).
Conclusions: This review demonstrates that trauma-related presentations in MGs are highly heterogeneous and influenced by event type and participant behavior. Soft-tissue injuries constitute the majority of reported trauma cases, while endurance/open-course sports and high-energy music events show higher trauma burdens. These findings support event-specific medical planning and trauma preparedness for in-event healthcare services.
(Copyright © 2026 Elsevier Inc. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests
Contributed Indexing: Keywords: disaster medicine; patient presentation rate; prehospital; transport to hospital rate; trauma care bundle
Entry Date(s): Date Created: 20260604 Date Completed: 20260714 Latest Revision: 20260714
Update Code: 20260714
DOI: 10.1016/j.jemermed.2026.04.019
PMID: 42242034
Βάση Δεδομένων: MEDLINE
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  Data: Investigation of Trauma Cases Presented to the In-Event Health Care Services in Mass Gatherings: A Systematic Review.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ekrem+&#199;ebi+G%22&quot;&gt;Ekrem &#199;ebi G&lt;/searchLink&gt;; Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkey.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ertan+A%22&quot;&gt;Ertan A&lt;/searchLink&gt;; Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkey; Department of Property Protection and Security, Vocational School, Biruni University, Istanbul, Turkey. Electronic address: aertan@biruni.edu.tr.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ege+Zilan+D%22&quot;&gt;Ege Zilan D&lt;/searchLink&gt;; Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkey.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ko&#231;ak+H%22&quot;&gt;Ko&#231;ak H&lt;/searchLink&gt;; Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kınık+K%22&quot;&gt;Kınık K&lt;/searchLink&gt;; Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Bek+Yağmur+&#214;%22&quot;&gt;Bek Yağmur &#214;&lt;/searchLink&gt;; Istanbul Provincial Health Directorate, Turkish Ministry of Health, Istanbul, Turkey.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22&#199;alışkan+C%22&quot;&gt;&#199;alışkan C&lt;/searchLink&gt;; Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey.
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  Data: Background: Mass gatherings (MGs) are associated with increased healthcare demand and may pose a risk for mass casualty incidents if medical services are not adequately planned. Trauma presentations constitute an important component of medical encounters during MGs; however, evidence regarding trauma patterns and preparedness requirements remains fragmented.&lt;br /&gt;Objective: The primary aim of this study was to examine rates of trauma-related presentations to in-event health care areas during MGs. Secondary aims were to identify trauma patterns across different event types, support planning of in-event health services and develop a practical checklist to assist trauma preparedness and response planning.&lt;br /&gt;Method: Following PRISMA guidelines, a systematic search was conducted across PubMed, Web of Science, and Scopus databases for studies published between 2015 and 2025. Articles were screened based on the PICOS framework, focusing on observational studies of MG participants exposed to trauma. Inclusion required the reporting of in-event healthcare data, while studies solely using hospital-based records or lacking trauma-specific metrics were excluded. Data were extracted using a standardized form to identify event characteristics, patient presentation rate (PPR), and transport to hospital rates (TTHR). The primary outcome was the incidence of trauma, while secondary outcomes included the identification of trauma subtypes (e.g., musculoskeletal, soft tissue).&lt;br /&gt;Results: The initial search yielded 382 articles. After removal of duplicates and exclusions, 18 relevant studies were included in the final synthesis. The proportion of trauma-related visits relative to all patients treated at in-event medical stations ranged from 11.7 to 81.7%. The highest trauma rate was reported at the European Youth Olympic Winter Festival (81.7%), whereas the Guadalajara International Book Fair reported the lowest (11.7%). Soft tissue injuries (13-42.3%) were the most prevalent across music and sporting events, followed by musculoskeletal injuries (3-35.7%). Events involving mosh pit behavior showed a distinct clustering of head and facial injuries (65%).&lt;br /&gt;Conclusions: This review demonstrates that trauma-related presentations in MGs are highly heterogeneous and influenced by event type and participant behavior. Soft-tissue injuries constitute the majority of reported trauma cases, while endurance/open-course sports and high-energy music events show higher trauma burdens. These findings support event-specific medical planning and trauma preparedness for in-event healthcare services.&lt;br /&gt; (Copyright &#169; 2026 Elsevier Inc. All rights reserved.)
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  Data: Declaration of competing interest The authors declare that they have no competing interests
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