Trends in Neurosurgical Management of Traumatic Brain Injury in Colombia

Abstract

Introduction: Traumatic brain injury (TBI) is a public health problem with higher impact in low and middle income countries. Surgical management of TBI in Colombia is a common intervention performed by neurosurgeons but there is little knowledge about their preferences and trends during the care. Materials and methods:We designed a 19 questions survey based on previous studies in high income settings. Through the Colombian Association of Neurosurgery website contact list, we submit the survey to 324 registered neurosurgeons. Statistical analysis was performed using frequencies of nominal and quantitative data. Results:The response number was 47 (14.8%). Around 97.8% were males and 66% have more than 5 years in practice. Thirty percent operate between 50 and 100 cases of TBI and 65.9% work in at least two facilities. The 95.74% consider that trauma surgery is not well paid by the system. Only 12.5% of the neurosurgeons are more devoted to neurotrauma and 20.8% are practicing more spine surgery. The 36.1% will choose not to do trauma neurosurgery if they have the opportunity. Resources for emergency craniotomies in their facilities were considered adequate by 93.6% of the responders. Conclusion:Caring for patients with neurotrauma is not an attractive option for some practicing neurosurgeons in Colombia. Traumatic brain injury cases are frequent in daily practice but some neurosurgeons prefer not to do trauma surgery if they have the option. Institutions have basic resources to perform trauma neurosurgery but the surgery is not well paid by the health system according to the neurosurgeons perspective.

International Neurotrauma Training Based on North-South Collaborations: Results of an Inter-institutional Program in the Era of Global Neurosurgery

“…This brings with it the most significant opportunities for advancement care. Nevertheless, young neurosurgeons seem to have more motivation for highly technological driven specialties like functional neurosurgery, endovascular, cerebrovascular, and skull-based neurosurgery (20)(21)(22). These, along with other highly reimbursing specialties like spine or tumor neurosurgery are incredibly lucrative and thus, highly sought after.…”