Awuah Wireko Andrew, Tan Joecelyn Kirani, Shah Muhammad Hamza, Ahluwalia Arjun, Roy Sakshi, Ali Syed Hasham, Ferreira Tomas, Bharadwaj Hareesha Rishab, Adebusoye Favour Tope, Aderinto Nicholas, Mazzoleni Adele, Abdul-Rahman Toufik, Ovechkin Denys
Faculty of Medicine Sumy State University Sumy Ukraine.
Faculty of Medicine University of St Andrews St. Andrews Scotland UK.
Health Sci Rep. 2024 Oct 23;7(10):e70151. doi: 10.1002/hsr2.70151. eCollection 2024 Oct.
The prevalence of abdominal injuries in war and conflict zones, particularly in low- and middle-income countries (LMICs), presents a significant healthcare challenge. These injuries, often resulting from explosive devices, firearms, and shrapnel, lead to high morbidity and mortality rates due to delayed diagnoses, inadequate medical infrastructure, and limited access to specialised care. This review aims to summarise the literature on conflict-related abdominal injuries in LMICs, highlighting the impact of such trauma on healthcare systems and patient outcomes, and suggesting strategies for improvement.
A comprehensive narrative review was conducted, focusing on studies from contemporary and historical conflict-ridden nations. Databases such as PubMed, EMBASE, Google Scholar, the Cochrane Library, and Scopus were searched using specific keywords. Inclusion criteria encompassed various study designs and both paediatric and adult populations, with studies providing raw data prioritised. Exclusions included non-English articles, non-peer-reviewed studies, and those not reporting outcomes or involving high-income countries.
The review identified significant challenges in managing war-related abdominal trauma in LMICs, including a shortage of healthcare personnel and infrastructure, socio-political barriers, and research gaps. Clinical implications of such injuries include elevated mortality rates, with surgical and nonsurgical management outcomes varying significantly. Positive advancements in diagnostics and surgical techniques have improved survival rates, yet the need for further infrastructural and workforce enhancements remains critical.
Abdominal trauma in conflict-affected LMICs necessitates focused efforts to improve healthcare delivery, including targeted funding for infrastructure and equipment, development of training programs for trauma specialists, and increased humanitarian aid. Bridging research gaps and fostering collaborative efforts are essential for advancing the management of abdominal trauma and enhancing patient outcomes in these challenging environments.
在战争和冲突地区，尤其是在低收入和中等收入国家（LMICs），腹部损伤的患病率构成了重大的医疗保健挑战。这些损伤通常由爆炸装置、枪支和弹片造成，由于诊断延误、医疗基础设施不足以及获得专科护理的机会有限，导致高发病率和死亡率。本综述旨在总结关于LMICs中与冲突相关的腹部损伤的文献，强调此类创伤对医疗系统和患者结局的影响，并提出改进策略。
进行了一项全面的叙述性综述，重点关注来自当代和历史上饱受冲突蹂躏国家的研究。使用特定关键词搜索了PubMed、EMBASE、谷歌学术、Cochrane图书馆和Scopus等数据库。纳入标准包括各种研究设计以及儿科和成人人群，优先考虑提供原始数据的研究。排除标准包括非英文文章、非同行评审研究以及未报告结局或涉及高收入国家的研究。
该综述确定了在LMICs中管理与战争相关的腹部创伤方面的重大挑战，包括医疗人员和基础设施短缺、社会政治障碍以及研究空白。此类损伤的临床影响包括死亡率升高，手术和非手术治疗结局差异显著。诊断和手术技术的积极进展提高了生存率，但进一步加强基础设施和劳动力的需求仍然至关重要。
受冲突影响的LMICs中的腹部创伤需要集中努力改善医疗服务，包括为基础设施和设备提供有针对性的资金、制定创伤专科医生培训计划以及增加人道主义援助。弥合研究空白并促进合作努力对于推进腹部创伤管理和改善这些具有挑战性环境中的患者结局至关重要。
