Poggetti Renato Sergio
3rd Division of Surgical Clinic, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
World J Surg. 2008 Aug;32(8):1626-9. doi: 10.1007/s00268-008-9659-9.
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.
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.
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.
在默里和洛佩兹所著的世界卫生组织书籍《全球疾病负担》中,作者指出全球因伤害导致的死亡存在重大区域差异。在欧洲市场经济体中,伤害占所有死亡人数的6%,其中大多数是道路交通事故所致。形成鲜明对比的是,在拉丁美洲和加勒比地区,伤害占所有死亡人数的12%至13%,其中大部分是暴力所致。估计所有男性死亡人数中有30%是由外部原因造成的,道路交通事故是第二大死因。在南美国家中,创伤是哥伦比亚、委内瑞拉、厄瓜多尔和巴西第二常见的死因。在其他南美国家,它是第三或第四常见的死因。如果考察伤残调整生命年,南美洲在世界上排名第三。伤害致死主要影响中低收入群体。交通事故和自杀是高收入人群创伤的主要原因。南美洲由发展中国家和贫穷国家组成,创伤是这些国家非常重要的死亡和残疾原因。
作者查阅了世界卫生组织、泛美卫生组织和巴西卫生部关于伤害的信息。此外,还通过医学文献数据库进行了伤害方面的检索。
本次综述结果表明,创伤是南美洲一个主要的公共卫生问题。目前,缺乏全州范围的系统发展。此外,在培训外科医生应对这些问题方面存在困难。