Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record.

Autor: Rock JP; Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA. Electronic address: jrock1@hfhs.org., Prentiss T; Department of Global Health Initiative, Henry Ford Health System, Detroit, Michigan, USA., Mo SM; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Myat Hnin Aye NS; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Asmaro K; Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA., Win AT; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Phyu AM; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Myat T; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Maung TM; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Khaing AA; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Naung Z; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Park KB; Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA., Hlaing K; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar., Myaing W; Department of Neurosurgery, North Okkalappa General Hospital, Yangon, Myanmar.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2020 Aug; Vol. 140, pp. e260-e265. Date of Electronic Publication: 2020 May 12.
DOI: 10.1016/j.wneu.2020.05.016
Abstrakt: Background: The treatment of traumatic brain injury (TBI) in Myanmar is a major health issue. Comprehensive appreciation of the pathology is limited given the lack of granular metadata available. In this proof-of-concept study, we analyzed demographic data on TBI generated from a novel, prospective, online database in a lower-middle income country.
Methods: Neurosurgery residents were given an electronic tablet for data entry into an online database. Metadata-driven data capture was carried out prospectively by trained residents, and the information was reviewed weekly by the supervising team in the United States.
Results: Complete data were available on 242/253 (96%) patients. Age at admission was 37 years (range 16-85), and length of stay was 3.53 days (1-21). Etiologies included motorcycle accidents, falls, assaults, pedestrian vehicular injuries, and industrial accidents. Dispositions were primarily to home (211). Average Glasgow Coma Scale score at admission was 12.97. There was a 68% mortality rate of patients directly admitted to the North Okkalappa General and Teaching Hospital with a Glasgow Coma Scale score <8 versus 75% for patients transferred in from other facilities. Surgery was performed on 30 patients (12.4%).
Conclusions: Despite a lack of formal training in electronic medical records or research, the resident team was able to capture the majority of admissions with granular-level data. This helped shed light on the etiology and severity of TBI in Myanmar. As a result, more effective transport systems and access to trauma care must be achieved. Accessible regional trauma centers with investment in intensive care units, operative care, anesthesia, and imaging resources are necessary.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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