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  1. Trauma mortality patterns in three nations at different economic levels : Implications for global trauma system development. Discussion.

    Article, Communication - En anglais

    Annual Meeting of the American Association for the Surgery of Trauma and the Japanese Association for Acute Medicine. Waikoloa, HI, USA, 1997/09/24.

    Background 

    Whereas organized trauma care systems have decreased trauma mortality in the United States, trauma system design has not been well addressed in developing nations.

    We sought to determine areas in greatest need of improvement in the trauma systems of developing nations.

    Methods 

    We compared outcome of all seriously injured (Injury Severity Score = 9 or dead), nontransferred, adults managed over I year in three cities in nations at different economic levels :

    • (1) Kumasi,

    • Ghana : low income, gross national product (GNP) per capita of $310, no emergency medical service (EMS) ;

    • (2) Monterrey,

    • Mexico : middle income,

    • GNP $3,900, basic EMS ;

    • and (3) Seattle,

    • Washington : high income,

    • GNP $25,000, advanced EMS.

    Each city had one main trauma hospital, from which hospital data were obtained.

    Annual budgets (in US$) per bed for these hospitals were as follows :

    • Kumasi, $4,100 ;

    • Monterrey, $68,000 ;

    • and Seattle, $606,000.

    Data on prehospital deaths were obtained from vital statistics registries in Monterrey and Seattle, and by an epidemiologic survey in Kumasi.

    Results 

    Mean age (34 years) and injury mechanisms (79% blunt) were similar in all locations.

    Mortality declined with increased economic level : Kumasi (63% of all seriously injured persons died), Monterrey (55%), and Seattle (35%). This decline was primarily due to decreases in prehospital deaths.

    In Ku-masi, 51% of all seriously injured persons died in the field ; in Monterrey, 40% ; and in Seattle, 21%. (...)

    Mots-clés Pascal : Traumatisme, Traitement, Etude comparative, Epidémiologie, Mortalité, Etats Unis, Amérique du Nord, Amérique, Afrique, Amérique Latine, Facteur sociodémographique, Homme, Urgence, Période préhospitalière, Milieu urbain, Facteur économique, Système soins

    Mots-clés Pascal anglais : Trauma, Treatment, Comparative study, Epidemiology, Mortality, United States, North America, America, Africa, Latin America, Sociodemographic factor, Human, Emergency, Prehospital period, Urban environment

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0276371

    Code Inist : 002B30A01A2. Création : 27/11/1998.