Jacquelyn Corley1, Jacob Lepard2, Ernest Barthélemy3, Joanna L Ashby4, Kee B Park5. 1. Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; Duke Department of Neurosurgery, Durham, North Carolina, USA. Electronic address: jacorley21@gmail.com. 2. Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA; Boston Children's Hospital, Boston, Massachusetts, USA. 3. Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 4. Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; University of Glasgow Medical School, Scotland, United Kingdom. 5. Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Among all trauma-related injuries globally, traumatic brain injury (TBI) and traumatic spine injury (TSI) account for the largest proportion of cases. Where previously data was lacking, recent efforts have been initiated to better quantify the extent of neurotrauma in low- and middle-income countries (LMICs). This information is vital to understand the current neurosurgical deficit so that resources and efforts can be focused on where they are needed most. The purpose of this study is to determine the minimum number of neurosurgeons to address the neurotrauma demand in LMICs and evaluate current evidence to support facility needs so that policy-based recommendations can be made to prioritize development initiatives to scale up neurosurgical services. METHODS: Using existing data regarding the incidence of TBI and TSI in LMICs and current neurosurgical workforce and estimates of case load capacity, the minimum number of neurosurgeons needed to address neurotrauma per population was calculated. Evidence was gathered regarding necessary hospital facilities and disbursement patterns based on time needed to intervene effectively for neurotrauma. RESULTS: There are 4,897,139 total operative cases of TBI and TSI combined in LMICs annually. At minimum, there needs to be 1 neurosurgeon only performing neurotrauma cases per approximately 212,000 people. Evidence suggests that patients should be within 4 hours of a neurosurgical facility at the very least. CONCLUSIONS: The development of neurotrauma systems is essential to address the large burden of neurotrauma in LMICs. The minimum requirements for neurosurgical workforce is 1 neurotrauma surgeon per 212,000 people.
BACKGROUND: Among all trauma-related injuries globally, traumatic brain injury (TBI) and traumatic spine injury (TSI) account for the largest proportion of cases. Where previously data was lacking, recent efforts have been initiated to better quantify the extent of neurotrauma in low- and middle-income countries (LMICs). This information is vital to understand the current neurosurgical deficit so that resources and efforts can be focused on where they are needed most. The purpose of this study is to determine the minimum number of neurosurgeons to address the neurotrauma demand in LMICs and evaluate current evidence to support facility needs so that policy-based recommendations can be made to prioritize development initiatives to scale up neurosurgical services. METHODS: Using existing data regarding the incidence of TBI and TSI in LMICs and current neurosurgical workforce and estimates of case load capacity, the minimum number of neurosurgeons needed to address neurotrauma per population was calculated. Evidence was gathered regarding necessary hospital facilities and disbursement patterns based on time needed to intervene effectively for neurotrauma. RESULTS: There are 4,897,139 total operative cases of TBI and TSI combined in LMICs annually. At minimum, there needs to be 1 neurosurgeon only performing neurotrauma cases per approximately 212,000 people. Evidence suggests that patients should be within 4 hours of a neurosurgical facility at the very least. CONCLUSIONS: The development of neurotrauma systems is essential to address the large burden of neurotrauma in LMICs. The minimum requirements for neurosurgical workforce is 1 neurotrauma surgeon per 212,000 people.
Authors: Faizal A Haji; Jacob R Lepard; Matthew C Davis; Nguyen Duc Lien; Dang Do Thanh Can; Cao Vu Hung; Le Nam Thang; Brandon G Rocque; James M Johnston Journal: Childs Nerv Syst Date: 2020-07-27 Impact factor: 1.475
Authors: Faith C Robertson; Sujit Gnanakumar; Claire Karekezi; Kerry Vaughan; Roxanna M Garcia; Bilal Abou El Ela Bourquin; Fahd Derkaoui Hassani; Alexander Alamri; Nesrine Mentri; Julius Höhne; Tsegazeab Laeke; Hosam Al-Jehani; Luis Rafael Moscote-Salazar; Ahmed Nasser Al-Ahmari; Nicolás Samprón; Martin N Stienen; Federico Nicolosi; Davi J Fontoura Solla; P David Adelson; Franco Servadei; Amro Al-Habib; Ignatius Esene; Angelos G Kolias Journal: World Neurosurg X Date: 2020-05-11
Authors: Faith C Robertson; Ignatius N Esene; Angelos G Kolias; Tariq Khan; Gail Rosseau; William B Gormley; Kee B Park; Marike L D Broekman Journal: World Neurosurg X Date: 2019-09-09
Authors: Andres M Rubiano; David S Vera; Jorge H Montenegro; Nancy Carney; Angelica Clavijo; Jose N Carreño; Oscar Gutierrez; Jorge Mejia; Juan D Ciro; Ninel D Barrios; Alvaro R Soto; Paola A Tejada; Maria C Zerpa; Alejandro Gomez; Norberto Navarrete; Oscar Echeverry; Mauricio Umaña; Claudia M Restrepo; Jose L Castillo; Oscar A Sanabria; Maria P Bravo; Claudia M Gomez; Daniel A Godoy; German D Orjuela; Augusto A Arias; Raul A Echeverri; Jorge Paranos Journal: J Neurosci Rural Pract Date: 2020-03-03