Global burden of emergency and operative conditions: an analysis of Global Burden of Disease data, 2011-2019.

Objective: To estimate the global burden of conditions requiring emergency or operative care and to investigate variations over time and between countries. Methods: We obtained data on deaths and disability-adjusted life years (DALYs) lost from the Global Burden of Disease database for 193 countries covering 2011 to 2019. We defined emergency conditions as conditions that, if not diagnosed and treated within hours to days of onset, often lead to serious physical or mental disability or death. We defined operative conditions as conditions that may require the expertise of a surgically trained provider and these conditions were identified using a modified Delphi consensus process. Findings: In 2019, emergency conditions accounted for 27 167 926 deaths and 1 015 000 000 DALYs globally, and operative conditions accounted for 17 648 680 deaths and 619 600 000 DALYs. Conditions classified as emergency-and-operative conditions accounted for 6 966 425 deaths and 303 344 808 DALYs. For emergency conditions, the per capita burden of deaths and DALYs was greatest for low-income countries. Between 2011 and 2019, deaths and DALYs due to emergency conditions decreased, whereas deaths due to operative conditions increased slightly. These trends may have been driven by strengthened prevention and early detection mechanisms, improved emergency care provision or epidemiological changes. However, because emergency and operative conditions were defined differently, it may not be valid to compare trends directly. Conclusion: The high global burden of emergency and operative conditions identified underscores the importance of strengthening and scaling up integrated emergency, critical and operative care internationally.