title: 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.
abstract: 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 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.
  
  
  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.
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Avenue, Suite 600, Seattle, Washington, 98121, USA, h.higashi@uqconnect.edu.au.
authors.forename: Hideki
authors.initials: H
authors.lastname: Higashi
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Barendregt
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Kassebaum
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Weiser
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Bickler
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
mesh_terms: D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D014943:Global Health / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D007182:Income; D011203:Poverty; D019057:Quality-Adjusted Life Years; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000601:surgery*