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

The Author(s) 2014. This article is published with open access at Springerlink.com Background 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. Methods We examined all causes of injury from the Global Burden of Disease 2010 Study. We split the dis-ability-adjusted life years (DALYs) for these conditions between surgically ‘‘avertable’ ’ and ‘‘nonavertable’ ’ bur-dens. 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 sur-gically avertable. Similarly, we applied the lowest nonfatal burden per case to each LMIC region. Results 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). Conclusions Basic surgical care has the potential to play a major role in reducing the injury-related burden in LMICs