The pivotal role of neurosurgeons in transitional care: A comprehensive tertiary healthcare institution's experience.

Autor: Chew Z; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore, Singapore. zakir.chew@mohh.com.sg.; Ministry of Health Holdings, Singapore, Singapore. zakir.chew@mohh.com.sg., Lim HL; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore, Singapore.; Ministry of Health Holdings, Singapore, Singapore., Mahmood S; Ministry of Health Holdings, Singapore, Singapore., Vedicherla S; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore, Singapore.; Ministry of Health Holdings, Singapore, Singapore., Kimpo MS; Division of Pediatric Haematology and Oncology, Department of Pediatrics, National University Hospital, Singapore, Singapore., Ong HT; Division of Pediatric Neurology, Department of Pediatrics, National University Hospital, Singapore, Singapore.; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Nga VD; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore, Singapore.; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Dec; Vol. 40 (12), pp. 4271-4278. Date of Electronic Publication: 2024 Oct 05.
DOI: 10.1007/s00381-024-06638-8
Abstrakt: Purpose: Transitional care (TC) is increasingly crucial, particularly in neurosurgery, where optimal follow-through of patients' care is paramount. Challenges of transition are exacerbated by the complexity of neurosurgical conditions, with pediatric and adult neurosurgery often managed separately by different attending neurosurgeons or in different institutions. While numerous models for transitioning have been proposed, several barriers persist, impeding successful transfer from pediatric to adult settings. Our review focuses on important roles neurosurgeons can play in facilitating successful transition, exploring some existing TC models, with emphasis on the benefits of maintaining a single provider.
Methods: Clinic visits data between 2019 to 2023 of patients between the ages of 16 to 26 was compiled retrospectively. Successful transition was defined as continued follow-up moving from pediatric to adulthood with lost to follow-up being that of unsuccessful transition. Age, diagnosis and whether patients were successfully transitioned or lost to follow-up were documented.
Results: 1829 neurosurgical patients between the ages of 16 to 26 were identified over 5 years. A snapshot review identified 78 adolescent patients deemed to require follow-up into adulthood. 13 patients had epilepsy, 32 central nervous system (CNS) tumors, 17 congenital conditions, 14 neurovascular, and 2 patients had idiopathic intracranial hypertension. All 78 were noted to have successfully transited into their adulthood (age 21 and beyond). Having the same providers; having pediatric and adult neurosurgery within the same institution, was the single most important factor in facilitating successful transition.
Conclusion: Neurosurgeons in institutions, particularly those with experience and competencies in both pediatric and adult care, can serve as crucial anchors during the transitional period. At our institution, the implementation of this continuity of care model has demonstrated remarkable success. Institutions with both pediatric and adult services would be uniquely positioned to develop and implement effective transitional care.
Competing Interests: Declarations. Ethical approval: All authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Consent for publication: Consent is given should the article be published. Conflict of interest: There was no conflict of interests among all authors. No financial or non-financial interests exist. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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