Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record.
Adolescent
Adult
Aged
Aged, 80 and over
Brain Injuries, Traumatic
/ epidemiology
Computers, Handheld
Databases, Factual
Developing Countries
Electronic Health Records
/ instrumentation
Female
Humans
Internship and Residency
Male
Middle Aged
Myanmar
/ epidemiology
Neurosurgeons
Neurosurgery
Proof of Concept Study
Young Adult
Electronic medical records
Myanmar
TBI
TBI database
TBI registry
Traumatic brain injury
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
04
03
2020
revised:
01
05
2020
accepted:
02
05
2020
pubmed:
16
5
2020
medline:
18
12
2020
entrez:
16
5
2020
Statut:
ppublish
Résumé
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. 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. 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%). 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.
Sections du résumé
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.
Identifiants
pubmed: 32413564
pii: S1878-8750(20)30976-1
doi: 10.1016/j.wneu.2020.05.016
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e260-e265Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.