World Journal of Surgery

, Volume 36, Issue 5, pp 959–963 | Cite as

An Estimate of the Number of Lives that Could be Saved through Improvements in Trauma Care Globally

  • Charles Mock
  • Manjul Joshipura
  • Carlos Arreola-Risa
  • Robert Quansah



Reducing the global burden of injury requires both injury prevention and improved trauma care. We sought to provide an estimate of the number of lives that could be saved by improvements in trauma care, especially in low income and middle income countries.


Prior data showed differences in case fatality rates for seriously injured persons (Injury Severity Score ≥9) in three separate locations: Seattle, WA (high income; case fatality 35%); Monterrey, Mexico (middle income; case fatality 55%); and Kumasi, Ghana (low income; case fatality 63%). For the present study, total numbers of injury deaths in all countries in different economic strata were obtained from the Global Burden of Disease study. The number of lives that could potentially be saved from improvements in trauma care globally was calculated as the difference in current number of deaths from trauma in low income and middle income countries minus the number of deaths that would have occurred if case fatality rates in these locations were decreased to the case fatality rate in high income countries.


Between 1,730,000 and 1,965,000 lives could be saved in low income and middle income countries if case fatality rates among seriously injured persons could be reduced to those in high income countries. This amounts to 34–38% of all injury deaths.


A significant number of lives could be saved by improvements in trauma care globally. This is another piece of evidence in support of investment in and greater attention to strengthening trauma care services globally.


  1. 1.
    World Health Organization (2010) Injuries and violence: the facts, Geneva, World Health Organization. Available from Accessed Feb 8, 2011
  2. 2.
    World Health Organization (2011) Global burden of disease 2008 data. Available from Accessed Nov 29, 2011
  3. 3.
    Arreola-Risa C, Mock CN, Padilla D et al (1995) Trauma care systems in urban Latin America: the priorities should be prehospital and emergency room management. J Trauma 39:457–462PubMedCrossRefGoogle Scholar
  4. 4.
    Mock CN, Adzotor KE, Conklin E (1993) Trauma outcomes in the rural developing world: comparison with an urban level I trauma center. J Trauma 35:518–523PubMedCrossRefGoogle Scholar
  5. 5.
    Mock CN, Jurkovich GJ, nii-Amon-Kotei D et al (1998) Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma 44:804–812 discussion 812–814PubMedCrossRefGoogle Scholar
  6. 6.
    Mock C, Maier RV, nii-Amon-Kotei D (1997) Low utilization of formal medical services by injured persons in a developing nation. J Trauma 42:504–513PubMedCrossRefGoogle Scholar
  7. 7.
    Mock CN, Ofosu A, Gish O (2001) Utilization of district health services by injured persons in a rural area of Ghana. Int J Health Plann Manage 6:19–32CrossRefGoogle Scholar
  8. 8.
    Mock C, Abantanga F, Goosen J (2009) Strengthening care of injured children globally. Bull WHO 87:382–389PubMedGoogle Scholar
  9. 9.
    Herndon DN (2007) Total burn care, 3rd edn. W. B. Saunders, PhiladelphiaGoogle Scholar
  10. 10.
    Mock C, Boland E, Acheampong F et al (2003) Long-term injury related disability in Ghana. Disabil Rehabil 25:732–741PubMedCrossRefGoogle Scholar
  11. 11.
    Husum H, Gilbert M, Wisborg T et al (2003) Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma 54:1188–1196PubMedCrossRefGoogle Scholar
  12. 12.
    Sasser S, Varghese M, Kellermann A et al (2005) Prehospital trauma care systems. World Health Organization, GenevaGoogle Scholar
  13. 13.
    Mock CN, Lormand JD, Goosen J et al (2004) Guidelines for essential trauma care. World Health Organization, GenevaGoogle Scholar
  14. 14.
    Aboutanos M, Mora F, Rodas E et al (2010) Ratification of IATSIC/WHO’s guidelines for essential trauma care assessment in the South American Region. World J Surg 34:2735–2744. doi:10.1007/s00268-010-0716-9 PubMedCrossRefGoogle Scholar
  15. 15.
    Arreola-Risa C, Mock C, Vega Rivera F et al (2006) Evaluating trauma care capabilities in Mexico with the World Health Organization’s guidelines for essential trauma care. Pan Am J Pub Health 19:94–103CrossRefGoogle Scholar
  16. 16.
    Mock CM, Nguyen S, Quansah R et al (2006) Evaluation of trauma care capabilities in four countries using the WHO-IATSIC guidelines for essential trauma care. World J Surg 30:946–956. doi:10.1007/s00268-005-0768-4 PubMedCrossRefGoogle Scholar
  17. 17.
    Quansah R, Mock C, Abantanga F (2004) Status of trauma care in Ghana. Ghana Med J 38:149–152Google Scholar
  18. 18.
    Nguyen S, Mock C (2006) Improvements in trauma care capabilities in Vietnam through use of the WHO-IATSIC guidelines for essential trauma care. Int J Inj Contr Saf Promot 13:125–127CrossRefGoogle Scholar
  19. 19.
    Laxminarayan R, Mills AJ, Breman JG et al (2006) Advancement of global health: key messages from the disease control priorities project. Lancet 367(9517):1193–1208PubMedCrossRefGoogle Scholar
  20. 20.
    Nathens A, Jurkovich GJ, Cummings P et al (2000) The effect of organized systems of trauma care on motor vehicle crash mortality. JAMA 283:1990–1994PubMedCrossRefGoogle Scholar
  21. 21.
    Nathens AB, Jurkovich GJ, Rivara FP (2000) Effectiveness of state trauma systems in reducing injury-related mortality: a national evaluation. J Trauma 48:25–30PubMedCrossRefGoogle Scholar
  22. 22.
    Rivara F, Mock C (2005) The 1,000,000 lives campaign. Inj Prev 11:321–323PubMedCrossRefGoogle Scholar
  23. 23.
    Rivara F, Mock C (2006) Tackling the toll of injuries. Washington Post Tuesday, August 22, page A15Google Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Charles Mock
    • 1
  • Manjul Joshipura
    • 2
  • Carlos Arreola-Risa
    • 3
  • Robert Quansah
    • 4
  1. 1.Harborview Injury Prevention and Research Center, Harborview Medical CenterUniversity of WashingtonSeattleUSA
  2. 2.Department of Violence and Injury Prevention and DisabilityWorld Health OrganizationGenevaSwitzerland
  3. 3.School of MedicineTecnologico de MonterreyMonterreyMexico
  4. 4.Department of SurgeryKwame Nkrumah University of Science and TechnologyKumasiGhana

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