Acute care surgeon South American model.
BACKGROUND
In the World Health Organization book by Murray and Lopez (The Global Burden of Disease), the authors make the point that there are major regional differences across the world for death from injury. In the European market economies, injuries accounted for 6% of all deaths, of which the majority were the result of road traffic accidents. In stark contrast, in Latin America and the Caribbean, injuries account for 12-13% of all deaths, and most of these are the result of violence. An estimated 30% of all male deaths are from external causes, and road traffic accidents are the number two cause of death. Within South American countries, trauma is the second most common cause of death in Columbia, Venezuela, Ecuador, and Brazil. In other South American countries, it is the third or fourth most common cause of death. If one examines the Disability Adjusted Life Years, South America is the third highest in the world. Death from injury primarily affects people in the middle- and low-income group. Traffic accidents and suicide are the main causes of trauma in the high-income population. South America is made up of developing and poor countries that have trauma as a very important cause of death and disability.


METHODS
The author has reviewed information on injury from the World Health Organization, Pan American Health Organization, and Brazilian Health Ministry. In addition, a search of injury was performed through MEDLINE.


CONCLUSIONS
The results of this review show that trauma is a major public health problem in South America. At the present time, there is a lack of statewide system development. In addition, there are difficulties in training surgeons to cope with these problems.
3rd Division of Surgical Clinic, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. poggetti@terra.com.br
Renato Sergio
RS
Poggetti
D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D002983:Clinical Competence; D006291:Health Policy; D006801:Humans; D013020:South America / Q000453:epidemiology; D014194:Traumatology / Q000193:education / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000601:surgery*