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Impact of trauma severity scales in bullfighting injuries management
Manuel José Torres-Jurado1, Juan Ramón Gómez-López2, Jeancarlos Jhosmer Trujillo-Díaz2
1Digestive Surgery Department, University Hospital of Salamanca, Salamanca, Spain. manueljostorresjurado@gmail.com.
Background:
Bullfighting-related trauma, common in rural Spain, often results in polytrauma requiring urgent care. This study evaluates the management and outcomes of bullfighting-related trauma at a level I hospital in Medina del Campo, Spain.
Methods:
A retrospective study of 154 patients with bullfighting-related trauma from 1998 to 2024 was conducted. Patients were classified by trauma severity using the New Injury Severity Score (NISS): mild (MT), moderate (MoT), moderate-severe (MST), and severe (ST). Demographic data, injury characteristics, surgical procedures, complications, and outcomes were analyzed, with comparisons made using trauma severity scales (RTS, AIS, ISS, NISS).
Results:
The cohort had a mean age of 32 years (IQR 23-52), with a male predominance (97%). Open trauma (74.7%) was most common, especially goring (85.1%) to the lower extremities and pelvis. Significant findings included fewer deep goring injuries in MT (77% vs. 100%, p = 0.013) and more lower extremity injuries in MT (65% vs. 44%, p < 0.001). Mortality was higher in the ST group (p < 0.001), with one intraoperative death. Surgical intervention was needed in 92.2% of cases, and the reoperation rate was higher in the ST group (p < 0.001). The NISS scale effectively predicted severity, with MT having a median NISS of 5 (IQR 4-9) compared to 57 in the ST group (p < 0.001).
Conclusion:
Bullfighting-related trauma often requires urgent care, and the NISS scale is effective in predicting injury severity. Early surgical intervention improves outcomes. Further multicenter studies are needed to confirm these findings.
