Orthopaedic research in low-income countries: A bibliometric analysis of the current literature

Graham, Simon Matthew; Brennan, Ciaran; Laubscher, Maritz; Maqungo, Sithombo; Lalloo, David G.; Perry, Daniel C.; Mkandawire, Nyengo; Harrison, William J.

doi:10.1051/sicotj/2019038

Cited by 26 publications

(22 citation statements)

References 17 publications

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“…Most studies were reported from HICs which is similar to the general orthopaedic literature [72] . In this review only 2 studies were conducted in LMICs [ 26 , 42 ] and 48% of the studies were from the USA.…”

Section: Limitationssupporting

confidence: 56%

The economic burden of open tibia fractures: A systematic review

Schade

Khatri

Nwankwo

et al. 2021

Injury

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Background: Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their economic burden is key to inform policy and help prioritise treatment.Methods: All studies were identified from a systematic search of Medline, Embase and the Cochrane Central Register of Controlled Trials. We included any human with a diagnosed open tibia fracture, following any intervention. The primary outcome was any costs reported or patient return to work status. Secondary outcomes included average length of stay, wage loss, absenteeism and complications such as infection, amputation and nonunion. Data was extracted and we performed a descriptive narrative summary.Results: We reviewed 1,204 studies from our searches. A total of 34 studies were included from 14 different countries. The average age was 37.7 years old and 76% of the patients were male. 6.5% were Gustilo I, 12% Gustilo II and 82% Gustilo III. Initial direct hospitalisation costs were reported to be between £356 to £126,479 with an average length of stay of 56 days (3.1-244). 89% of participants were working preinjury, 60% fully returned to work, 17% returned to work part time or changed profession and 22% did not return to work at one-year. The most common complications reported were 22% infection, 11% nonunion and 16% amputation. Mean follow-up duration for the studies was 25 months. Conclusion:The economic burden of open tibia fractures varies greatly, but it is costly for both hospitals and patients. The current evidence is predominantly from high-income countries (HICs), especially the USA. Further research is required to investigate the costs of open tibia fractures using validated costing tools, especially in low-income countries (LICs), to help inform and direct policy.

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Section: Limitationssupporting

confidence: 56%

The economic burden of open tibia fractures: A systematic review

Schade

Khatri

Nwankwo

et al. 2021

Injury

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“…Our results show that a substantial proportion (more than 80%) of the existing research on post-discharge patients comes from high-income settings. This is in line with research on orthopedic trauma [ 43 ], fractures [ 44 ], and TBI [ 45 ] that similarly show low trauma research outputs from LMIC settings. This means that the current knowledge on post-discharge outcomes in trauma patients is largely based on evidence from high-income settings [ 46 – 48 ].…”

Section: Discussionsupporting

confidence: 84%

Measuring post-discharge socioeconomic and quality of life outcomes in trauma patients: a scoping review

David

Roy

Solomon

et al. 2021

J Patient Rep Outcomes

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Purpose Trauma is a global public health challenge. Measuring post-discharge socioeconomic and quality-of-life outcomes can help better understand and reduce the consequences of trauma. Methods We performed a scoping review to map the existing research on post-discharge outcomes for trauma patients, irrespective of the country or setting in which the study was performed. The scoping review was conducted by searching six databases – MEDLINE, EMBASE, the Cochrane Library, Global Index Medicus, BASE, and Web of Science – to identify all articles that report post-discharge socioeconomic or quality of life outcomes in trauma patients from 2009 to 2018. Results Seven hundred fifty-eight articles were included in this study, extracting 958 outcomes. Most studies (82%) were from high-income countries (HICs). More studies from low- and middle-income countries (LMICs) were cross-sectional (71%) compared with HIC settings (46%). There was a wide variety of different definitions, interpretations, and measurements used by various articles for similar outcomes. Quality of life, return to work, social support, cost, and participation were the main outcomes studied in post-discharge trauma patients. Conclusions The wide range of outcomes and outcome measures reported across different types of injuries and settings. This variability can be a barrier when comparing across different types of injuries and settings. Post-discharge trauma studies should move towards building evidence based on standardized measurement of outcomes.

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“…Studies from MICs tended to score low in their methodological appraisal. This is comparable with other research on different sub-groups of trauma, such as orthopedic fractures and brain injuries, which shows that LMICs are under-represented in trauma research (100)(101)(102). Even the existing research from LMICs is represented by less than onefifth of the constituent countries (103).…”

Section: Discussionsupporting

confidence: 83%