Children in poorer countries are six times higher risk of dying after emergency surgery

Children who need life saving emergency surgery after a serious injury are almost six times more likely to die if in poorer countries than in wealthier ones, according to an international study led by the University of Cambridge.

The research, published in The Lancet Child & Adolescent Health, analysed 237 children aged 18 and under who underwent trauma laparotomy – emergency surgery for severe abdominal injuries – in 85 hospitals across 32 countries.

Traumatic injuries, including those caused by road traffic accidents and violence, are among the leading causes of death and disability in children and adolescents worldwide.

This study looked at children who needed emergency surgery for severe abdominal injuries, comparing their care and outcomes across hospitals around the world.

Overall, 8% of children in the study died within 30 days of surgery.

After taking account of differences between patients and settings, children treated in countries with lower levels of development were almost six times more likely to die than those treated in countries with higher levels of development.

The study found major differences in the care children received, which are likely to be important in understanding why outcomes were worse in poorer countries.

Children often faced longer delays before reaching hospital and before receiving surgery.

They were also less likely to receive a blood transfusion, have a CT scan, receive medicine used to reduce bleeding, or be operated on by a consultant surgeon.

Children also made up a larger share of these cases in poorer countries than in wealthier ones.

This suggests that poorer countries may face a double challenge: more children needing emergency surgery after trauma, and less access to the care needed to treat them.

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Source: Surgery, 15 June 2026