Burden of Injuries Avertable By a Basic Surgical Package in Low- and Middle-Income Regions: A Systematic Analysis From the Global Burden of Disease 2010 Study
Burden of Injuries Avertable By a Basic Surgical Package in Low- and Middle-Income Regions: A Systematic Analysis From the Global Burden of Disease 2010 Study
复制标题
DOI：
10.1007/s00268-014-2685-x
复制
发表时间：
2015-01-01
影响因子：
2.6
通讯作者：
Vos, Theo
中科院分区：
文献类型：
--
作者：
Higashi, Hideki;Barendregt, Jan J.;Vos, Theo
2010年，伤害占全球疾病负担的11%。这项研究旨在量化低收入和中等收入国家(LMIC)的伤害负担，如果向所有人提供基本的手术服务，那么可以避免的伤害负担。我们检查了2010年全球疾病负担研究中的所有伤害原因。我们将这些疾病的伤残调整生命年(DALY)分为手术“可避免的”和“不可避免的”负担。为了估计可避免的死亡负担，我们将21个流行病学地区中的最低死亡率应用到每个LMIC地区，假设每个地区之间的死亡率差异和最低死亡率反映了外科护理的差距。我们对到达医院之前发生的致命病例进行了调整，因为它们不是手术可以避免的。同样，我们对每个LMIC区域应用了每个病例最低的非致命性负担。总体而言，LMIC中21%的伤害负担可能是可以通过基本手术治疗避免的(5230万DALY)。死亡的平均比例高于非致命负担(23%对20%)，这表明针对受伤的外科服务比改善残疾更有效地挽救生命。撒哈拉以南非洲的潜在可避免负担比例最大(25%)。南亚的平均DALY总数最高(1,740万)。道路伤害是LMICs中最大的可避免负担(1610万DALYs)。基础外科护理有可能在减轻LMICs中与伤害相关的负担方面发挥重要作用。
Injuries 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.We 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.Overall, 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).Basic surgical care has the potential to play a major role in reducing the injury-related burden in LMICs.