Time to invest in trauma care

Up to two million lives, annually, could be saved globally with improvements in trauma care, particularly in low- and middle-income countries. This estimate by Charles Mock, from the University of Washington in Seattle, and his team provides support for investment in and greater attention to strengthening trauma care services globally. Their work is published online in Springer's World Journal of Surgery.

There are significant differences in survival rates of severely injured individuals in countries at different economic levels. For example, in Seattle in the US (high income), the mortality rate from serious injury is approximately 35 percent, compared with 55 percent in Monterrey in Mexico (middle-income) and 63 percent in Kumasi in Ghana (low-income). Overall, 90 percent of trauma deaths occur in low- and middle-income countries, where resources are limited.

Mock and colleagues' work estimates how many lives could be saved if these differences in survival rates between countries at different economic levels could be reduced i.e. if they were all brought down to the 35 percent mark.

The researchers obtained data on the total number of trauma deaths in countries in different economic strata. Their calculations suggest that between 1.7 and 2 million lives could be saved in low- and middle-income countries if fatality rates among seriously injured individuals could be reduced to those in high-income countries.

To achieve a reduction in unnecessary trauma deaths, the authors suggest improvements in both pre-hospital care – for example expansion of basic ambulance services and provision of basic first aid in the field - and hospital care itself. This includes providing more staff and equipment, more regular use of continuing education courses for trauma care, and implementation of trauma care improvement programs.

The authors conclude: "Implementing improvements in trauma care capabilities more widely could save a significant number of lives. Although the figure of nearly two million lives saved remains a long range vision requiring global investment, even small improvements in trauma care capabilities could have significant effects. What's more, such improvements in care are eminently affordable and cost-effective."