International Orthopaedic Trauma Association Supplement: International Trauma Systems
Injury is the leading cause of death under the age of 45, with road traffic injuries accounting for 1.2 million deaths and 20 to 50 million nonfatal injuries worldwide every year.[2,3] Around 90% of these deaths occur in lower and middle-income countries (LMICs). Further, reports estimate that surgical diseases account for approximately 11% of global disability-adjusted life years, disproportionately affecting LMICs.
Recently, there has been increased interest in evidence-based interventions and emphasis on the evaluation and implementation of trauma systems worldwide. In 2004, the World Health Organization published recommendations on how to improve essential trauma care in order to reduce trauma-related mortality. Well-developed trauma systems in higher income countries have been shown to improve patient outcomes; however the overall adoption of these systems remains low.[1,8] A recent literature review showed that despite sufficient resources, only 9 of 32 high-income countries evaluated had documented trauma systems in place.
Musculoskeletal injury represents a critical subset of trauma-related conditions and a major cause of long-term disability, yet it receives less attention than many other health conditions. Effective treatment of these injuries relates directly to the overall trauma care systems in place, particularly as they relate to entire post-injury healthcare delivery processes, from prehospital to hospital to rehabilitative care. The state of existing trauma care systems worldwide is not well documented, and limited guidance exists to help improve these systems, particularly in lower resource settings.
This supplement seeks to describe trauma systems in countries throughout the world. This work represents a collaboration of member societies of the International Orthopaedic Trauma Association, which is an international association of orthopaedic societies dedicated to the promotion of musculoskeletal trauma care through advancements in treatment, education, and research. The information presented in this supplement will contribute to larger efforts toward understanding, improving, and standardizing existing trauma systems worldwide.
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in an East African public hospital. Injury. 2004;35:401–406.