Abstract
BackgroundInjuries accounted for 11 % of the global burden of disease in 2010. This study aimed to quantify the burden of injury in low- and middle-income countries (LMICs) that could be averted if basic surgical services were made available and accessible to the entire population.MethodsWe examined all causes of injury from the Global Burden of Disease 2010 Study. We split the disability-adjusted life years (DALYs) for these conditions between surgically “avertable” and “nonavertable” burdens. For estimating the avertable fatal burden, we applied the lowest fatality rates among the 21 epidemiologic regions to each LMIC region, assuming that the differences in death rates between each region and the lowest rates reflect the gap in surgical care. We adjusted for fatal cases that occur prior to reaching hospitals as they are not surgically avertable. Similarly, we applied the lowest nonfatal burden per case to each LMIC region.ResultsOverall, 21 % of the injury burden in LMICs was potentially avertable by basic surgical care (52.3 million DALYs). The avertable proportion was greater for deaths than for nonfatal burden (23 vs. 20 %), suggesting that surgical services for injuries more effectively save lives than ameliorate disability. Sub-Saharan Africa had the largest proportion of potentially avertable burden (25 %). South Asia had the highest total avertable DALYs (17.4 million). Road injury comprised the largest total avertable burden in LMICs (16.1 million DALYs).ConclusionsBasic surgical care has the potential to play a major role in reducing the injury-related burden in LMICs.Electronic supplementary materialThe online version of this article (doi:10.1007/s00268-014-2685-x) contains supplementary material, which is available to authorized users.
Highlights
The Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2010 Study reported that 5 million deaths and 279 million disability-adjusted life years (DALYs) globally were due to injuries in 2010 [1]
This study aimed to quantify the burden of injury in low- and middle-income countries (LMICs) that could be averted if basic surgical services were made available and accessible to the entire population
Sub-Saharan Africa had the largest proportion of potentially avertable burden (25 %), and South Asia had the highest total number of avertable DALYs (17.4 million) among the LMIC superregions
Summary
The Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2010 Study reported that 5 million deaths and 279 million disability-adjusted life years (DALYs) globally were due to injuries in 2010 [1]. Injuries accounted for 11 % of the total disease burden globally (2,490 million DALYs) in both high-income countries (HICs) and lowand middle-income countries (LMICs). The proportion of injury-related burden to the total burden was virtually identical between HICs and LMICs in 2010, there were some notable differences. World J Surg (2015) 39:1–9 in HICs but an increasing trend in LMICs. Second, road injury, falls, and self-harm were the top three causes of injury burden globally, their relative importance differed. Road injury, falls, and self-harm were the top three causes of injury burden globally, their relative importance differed These three causes contribute more or less to the injury burden in HICs (25, 26, and 21 %, respectively), whereas road injuries clearly dominate in LMICs (27, 11, and 12 %, respectively). This study aimed to quantify the burden of injury in low- and middle-income countries (LMICs) that could be averted if basic surgical services were made available and accessible to the entire population
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