BACKGROUND: Traumatic brain injuries are a frequent cause of death and a substantial source of morbidity. Neurosurgeons (NS) are commonly involved in the management of patients with moderate and severe traumatic brain injuries to minimize morbidity from both primary and secondary brain injuries. However, NS willing to care for injured patients have become increasingly scarce. Although many institutions have been individually affected by shortages of NS providing care to injured patients, data on regional changes in NS availability and the effect on patient care are limited. METHODS: We queried a state discharge database for all traumatic intracranial hemorrhages (ICH) and skull fractures from 2004 to 2007 by International Classification of Diseases-9th Rev.-Clinical Modification codes. Institutions were categorized as those that admitted >30 or <30 ICH patients per year. The state medical society provided the number of NS practicing in the state per year. RESULTS: The total number of patients with significant head injuries increased over the study period. The number of NS decreased over the same time period. A greater proportion of patients were managed in centers admitting >30 ICH per year, and the number of facilities admitting <30 ICH per year decreased. CONCLUSION: In this state, increasing numbers of patients with ICH are being concentrated in a small number of centers, while the number of NS available to care for them has decreased. Shortages in neurosurgical workforce for patients with traumatic ICH have the potential for catastrophic consequences on a regional basis if effective solutions to this manpower issue are not created.
BACKGROUND:Traumatic brain injuries are a frequent cause of death and a substantial source of morbidity. Neurosurgeons (NS) are commonly involved in the management of patients with moderate and severe traumatic brain injuries to minimize morbidity from both primary and secondary brain injuries. However, NS willing to care for injured patients have become increasingly scarce. Although many institutions have been individually affected by shortages of NS providing care to injured patients, data on regional changes in NS availability and the effect on patient care are limited. METHODS: We queried a state discharge database for all traumatic intracranial hemorrhages (ICH) and skull fractures from 2004 to 2007 by International Classification of Diseases-9th Rev.-Clinical Modification codes. Institutions were categorized as those that admitted >30 or <30 ICHpatients per year. The state medical society provided the number of NS practicing in the state per year. RESULTS: The total number of patients with significant head injuries increased over the study period. The number of NS decreased over the same time period. A greater proportion of patients were managed in centers admitting >30 ICH per year, and the number of facilities admitting <30 ICH per year decreased. CONCLUSION: In this state, increasing numbers of patients with ICH are being concentrated in a small number of centers, while the number of NS available to care for them has decreased. Shortages in neurosurgical workforce for patients with traumatic ICH have the potential for catastrophic consequences on a regional basis if effective solutions to this manpower issue are not created.
Authors: Megan Rajagopal; Joseph Boyle; Vishal Patel; Charles Opalak; Dennis J Rivet; John Reavey-Cantwell Journal: World Neurosurg Date: 2021-09-06 Impact factor: 2.104
Authors: Rachel Blue; Andrew I Yang; Cecilia Zhou; Emma De Ravin; Clare W Teng; Gabriel R Arguelles; Vincent Huang; Connor Wathen; Stephen P Miranda; Paul Marcotte; Neil R Malhotra; William C Welch; John Y K Lee Journal: World Neurosurg Date: 2020-05-16 Impact factor: 2.104
Authors: Stephen W Cooper; Kimberly B Bethea; Trevor J Skrobut; Rod Gerardo; Karen Herzing; Juan Torres-Reveron; Akpofure Peter Ekeh Journal: Trauma Surg Acute Care Open Date: 2019-11-17