Evaluating Gulf Cooperation Council Trauma Care Infrastructure: A Scoping Review of Key Components and Gaps.

Abstract

Background: Trauma systems are multifaceted frameworks that optimize patient care and outcomes. The development of trauma systems has been a regional priority in the Gulf Cooperation Council (GCC), yet implementation varies across countries. These variations contribute to measurable differences in system performance and patient outcomes. A systematic mapping of these disparities can guide efforts to harmonize standards and enhance trauma-care delivery throughout the region.

Methods: A scoping review was conducted per PRISMA-ScR guidelines. PubMed, Scopus, and the Cochrane Library databases were searched for English-language publications (2000-2024) on prehospital emergency care, hospital-based trauma management, or post-hospital rehabilitation in GCC countries. Two reviewers independently screened and charted eligible studies; articles addressing only clinical outcomes without system-level discussion were excluded. Gray literature sources included Ministry of Health (MOH) websites, local news reports, and expert opinion.

Results: Of 1758 studies, 51 were fully screened, and 43 met the inclusion criteria. All GCC countries, except for UAE, operate a single centralized EMS system via a uniform national emergency number. Fleet sizes range from 36 ambulances in Bahrain to over 1379 in Saudi Arabia, with mean response times ranging from 5.3 min in Qatar to 15 min nationally in Kuwait. Formal trauma centers are limited in the region: Bahrain has no formal trauma centers, Qatar and Kuwait each have one dedicated trauma center (level 1 and 2 equivalent, respectively), Oman has two (level 2 and level 3 equivalent), Saudi Arabia has two (level 1 equivalent), and the UAE has nine (levels 1-3 equivalent). Local trauma registries exist in all countries, with a national trauma registry only in Qatar. Posthospital rehabilitation, although variable in resources, is delivered through MOH networks in all countries and supplemented by private providers.

Conclusion: Despite progress, gaps persist in trauma center accreditations, national registry development, and formation of integrated rehabilitation networks. Concerted improvements could further enhance trauma care delivery in the region with a desired improvement in overall outcomes.