Injury-to-Admission Delay Beyond 4 Hours Is Associated with Worsening Outcomes for Traumatic Brain Injury in Cambodia

Barthélemy, Ernest J.; Spaggiari, Riccardo; Corley, Jacquelyn; Lepard, Jacob; Staffa, Steven J.; Vycheth,; Servadei, Franco; Park, Kee B.

doi:10.1016/j.wneu.2019.02.019

Cited by 33 publications

(21 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Factors possibly contributing to inpatient deaths were delay in seeking help and higher injury severity. Delay to initial treatment has implications as well, since poor outcomes have been identified for patients presenting for care after more than four hours after injury [17]. Reasons for delay in seeking care may include lack of access to a medical facility, personal dislike for seeing a physician, and perception of no immediate clinical change after fall.…”

Section: Plos Onementioning

confidence: 99%

When falls become fatal—Clinical care sequence

et al. 2021

View full text Add to dashboard Cite

Objectives This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indirectly from injuries sustained during a fall, regardless of the temporal relationship. This comprehensive approach provides an unusual illustration of the clinical sequence of fall–related deaths. Understanding this pathway lays the groundwork for identification of gaps in healthcare needs. Design This is a retrospective study of 2014 fall-related deaths recorded by one medical examiner’s office (n = 511) within a larger dataset of all trauma related deaths (n = 1848). Decedent demographic characteristics and fall-related variables associated with the deaths were coded and described. Results Of those falling, 483 (94.5%) were from heights less than 10 feet and 394 (77.1%) were aged 65+. The largest proportion of deaths (n = 267, 52.3%) occurred post-discharge from an acute care setting. Of those who had a documented prior fall, 216 (42.3%) had a history of one fall while 31 (6.1%) had ≥2 falls prior to their fatal incident. For the 267 post-acute care deaths, 440 healthcare admissions were involved in their care. Of 267 deaths occurring post-acute care, 129 (48.3%) were readmitted within 30 days. Preventability, defined as opportunities for improvement in care that may have influenced the outcome, was assessed. Of the 1848 trauma deaths, 511 (27.7%) were due to falls of which 361 (70.6%) were determined to be preventable or potentially preventable. Conclusion Our data show that readmissions and repeated falls are frequent events in the clinical sequence of fall fatalities. Efforts to prevent fall-related readmissions should be a top priority for improving fall outcomes and increasing the quality of life among those at risk of falling.

show abstract

Section: Plos Onementioning

confidence: 99%

When falls become fatal—Clinical care sequence

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Timely access to neurosurgical care is essential for the management of neurotrauma. In low- and middle-income countries, the golden hour for traumatic brain injury is 4 h [ 1 ]. Hence, neurosurgical workforce density can inform the policymakers and complement nationwide strategic plans to expand the number of neurosurgical centers so no patient lives more than 4 h away from the point of definitive care.…”

Section: Why Should We Measure Neurosurgical Workforce Density?mentioning

confidence: 99%

Global neurosurgical workforce density—you cannot improve what you do not measure

Kanmounye¹,

Ammar

Rolle

et al. 2021

Chin Neurosurg Jl

Self Cite

View full text Add to dashboard Cite

show abstract

“…Traumatic brain and spine injuries often require urgent neuroimaging and, when necessary, emergent surgical treatment [11,12]. It is suggested that for expecting a favorable outcome, admission to facilities offering definitive care should be within 4 hours post injury for traumatic brain injuries [13] and 24 hours post injury for traumatic spine injuries [12]. In Cameroon, an estimated 73,000 new cases of traumatic brain and spine injuries occur annually [14], which could be admitted by only 8 public and military level 1 referral neurosurgical centers.…”

Section: Plain Language Summarymentioning

confidence: 99%

The Implications of Global Neurosurgery for Low- and Middle-income Countries: The Case of Cameroon

Kanmounye¹,

Ghomsi²,

Djiofack³

et al. 2020

Iran J Neurosurg

View full text Add to dashboard Cite

The unequal distribution of neurosurgical resources and diseases in the world contributes to inequality. Eight in 10 neurosurgical cases needing essential neurosurgical care are found in Low- and Middle-Income Countries (LMICs); however, LMICs lack the neurosurgical resources to address these needs. Besides, where neurosurgical care is available, it is not financially accessible to the majority of patients. Global Neurosurgery is a rapidly growing field that places a priority on improving health outcomes and achieving health equity for all people affected by neurosurgical conditions. To achieve safe, accessible, and affordable neurosurgical care for all, LMIC neurosurgeons should participate in national and international global neurosurgical activities, develop disruptive solutions to local problems and work with local stakeholders to address global neurosurgery problems.

show abstract

Injury-to-Admission Delay Beyond 4 Hours Is Associated with Worsening Outcomes for Traumatic Brain Injury in Cambodia

Cited by 33 publications

References 18 publications

When falls become fatal—Clinical care sequence

When falls become fatal—Clinical care sequence

Global neurosurgical workforce density—you cannot improve what you do not measure

The Implications of Global Neurosurgery for Low- and Middle-income Countries: The Case of Cameroon

Contact Info

Product

Resources

About