Do neurosurgeons follow the guidelines? A world-based survey on severe traumatic brain injury.

Autor:	Saraceno G; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Servadei F; Humanitas Reasearch Hospital-IRCCS and Humanitas University, Rozzano, Milan, Italy., Terzi DI Bergamo L; IOR Institute of Oncology Research, Bellinzona, Switzerland., Iaccarino C; Division of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, University Hospital of Modena, Modena, Italy., Rubiano AM; Neuroscience Institute, El Bosque University, Bogotà, Colombia.; Meditech Foundation, Cali, Colombia., Zoia C; Department of Neurosurgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy., Raffa G; Department of Neurosurgery, Messina University Hospital, Messina, Italy., Hawryluk G; Section of Neurosurgery Winnipeg Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada., Grotenhuis A; Department of Neurosurgery, Radboud University, Nijmegen, the Netherlands., Demetriades AK; Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK., Sala F; Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, Verona University Hospital, Verona, Italy., Belotti F; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy - francesco.belotti@unimi.it., Zanin L; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Doglietto F; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Panciani PP; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Biroli A; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Agosti E; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Serioli S; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Rasulic L; Clinic for Neurosurgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Bruneau M; Department of Neurosurgery, Vrije Universiteit Brussel (VUB), Brussels, Belgium., Germano IM; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Bosnjak R; Department of Neurosurgery, University Medical Center Ljubljana, Ljubljana, Slovenia., Thomé C; Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria., Regli L; Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Vukic M; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia., Tessitore E; Unit of Neurosurgery, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland., Schaller K; Unit of Neurosurgery, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland., Chaurasia B; Department of Neurosurgery, Bhawani Hospital and Research Center, Saraiyaganj, Muzaffarpur, Birgunj, Nepal., El-Ghandour NMF; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt., DI Ieva A; Department of Clinical Medicine, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, Australia., Bongetta D; Department of Neurosurgery, ASST Fatebenefratelli Sacco, Milan, Italy., Borghesi I; Department of Neurosurgery, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy., Fazio M; Department of Neurosurgery, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy., Esene IN; Division of Neurosurgery, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon., Rosseau G; Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA., El Abbadi N; Department of Neurosurgery, International Cheikh Zaid Hospital, Abulcassis University of Health Sciences, Rabat, Morocco., Baccanelli M; Department of Neurosurgery, Buenos Aires Italian Hospital, Buenos Aires, Argentina., Vajkoczy P; Department of Neurosurgery, Charité Medical University, Berlin, Germany., Fontanella MM; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgical sciences [J Neurosurg Sci] 2021 Oct; Vol. 65 (5), pp. 465-473.
DOI:	10.23736/S0390-5616.21.05475-8
Abstrakt:	Background: Traumatic brain injury (TBI) is going to be the third-leading cause of death worldwide, according to the WHO. Two European surveys suggested that adherence to brain trauma guidelines is poor. No study has compared compliance between low- (LMICs) and high-income (UHICs) countries. Hence, this study aimed to investigate differences in the management of severe TBI patients, comparing low- and high-income, and adherence to the BTF guidelines. Methods: A web-based survey was spread through the Global Neuro Foundation, different neurosurgical societies, and social media. Results: A total of 803 neurosurgeons participated: 70.4 from UHICs and 29.6% from LMICs. Hypertonic was administered as an early measure by the 73% and 65% of the responders in LMICs and UHICs, respectively (P=0.016). An invasive intracranial pressure monitoring was recommended by the 66% and 58% of the neurosurgeons in LMICs and UHICs, respectively (P<0.001). Antiseizure drugs (P<0.001) were given most frequently in LMICs as, against recommendations, steroids (87% vs. 61% and 86% vs. 81%, respectively). In the LMICs both the evacuation of the contusion and decompressive craniectomy were performed earlier than in UHICs (30% vs. 17% with P<0.001 and 44% vs. 28% with P=0.006, respectively). In the LMICs, the head CT control was performed mostly between 12 and 24 hours from the first imaging (38% vs. 23%, P<0.001). Conclusions: The current Guidelines on TBI do not always fit to both the resources and circumstances in different countries. Future research and clinical practice guidelines should reflect the greater relevance of TBI in low resource settings.
Databáze:	MEDLINE
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