Traumatic spinal injury (TSI) results from injury to bony, ligamentous, and/or neurologic structures of the spinal column and can cause significant morbidity and mortality. The global burden of TSI ...is poorly understood, so we performed a systematic review and meta-analysis to estimate the global volume of TSI.
We performed a systematic review through PubMed, Embase, and Cochrane Databases on TSI studies reported from 2000 to 2016. Collected data were used to perform a meta-analysis to estimate the annual incidence of TSI across World Health Organization regions and World Bank income groups using random-effect models. Incorporating global population figures, the annual worldwide volume of TSI was estimated.
A total of 102 studies were included in the systematic review and 19 studies in the meta-analysis. The overall global incidence of TSI was 10.5 cases per 100,000 persons, resulting in an estimated 768,473 95% confidence interval, 597,213–939,732 new cases of TSI annually worldwide. The incidence of TSI was higher in low- and middle-income countries (8.72 per 100,000 persons) compared with high-income countries (13.69 per 100,000 persons). Road traffic accidents, followed by falls, were the most common mechanism of TSI worldwide. Overall, 48.8% of patients with TSI required surgery.
TSI is a major source of morbidity and mortality throughout the world. Largely preventable mechanisms, including road traffic accidents and falls, are the main causes of TSI globally. Further investigation is needed to delineate local and regional TSI incidences and causes, especially in low- and middle-income countries.
•TSI is a major source of morbidity and mortality throughout the world.•Males were more likely affected by TSI in all WHO regions and World Bank income levels.•Preventable mechanisms, including RTAs and falls, are main causes of TSI globally.•The neurosurgical community must work to strength global neurosurgical capacity to TSI management.
Global Neurosurgery: The Unmet Need Park, Kee B., M.D; Johnson, Walter D., M.D., FACS; Dempsey, Robert J., M.D., FACS
World neurosurgery,
04/2016, Letnik:
88
Journal Article
Recenzirano
Odprti dostop
Abstract Globally, the lack of access to basic surgical care causes three times as much deaths as HIV/AIDS, Tuberculosis, and Malaria combined. The magnitude of this unmet need has been recently ...described, and the numbers are startling. Major shifts in global health agenda has highlighted access to essential and emergency surgery as high priority. A broad examination of the current global neurosurgical efforts to improve access has revealed some strengths particularly in the realm of training. However, the demand grossly outstrips the supply; most people in low income countries do not have access to basic surgical care– either due to lack of availability or affordability. Projects that help create a robust and resilient health system within LMICs require urgent implementation. In this context, concurrent scale-up of manpower, investments in capacity building, local data collection, and analysis for accurate assessment are essential. Additionally, through process of collaboration and consensus building within the neurosurgical community, a unified voice of neurosurgery is necessary to effectively advocate for all those who need neurosurgical care wherever, whenever.
The Lancet Commission on Global Surgery has recently focused its attention on the lack of surgical care worldwide. Like other surgical subspecialties, neurosurgical care needs to be better ...distributed around the world, with a major focus on low- to middle-income countries. Neurosurgical diseases like hydrocephalus, traumatic brain injury, and brain tumors have a high impact on families, individual quality of life, and cost for the society. Implementation of neurosurgical care in poor settings is not easy. More than other surgeries, neurosurgery requires great amounts of human resources, dedicated environments, and specialized postoperative care. It is responsibility of the neurosurgical community to identify major areas of current gaps and outline strategies for intervention.
•Global neurosurgery is a critical necessity among global surgery.•Global neurosurgery has been off the government priority list for years.•Neurosurgical resources do not cover all the LMICs needs.•Many initiatives have been proposed to improve neurosurgical care in LMICs.•World neurosurgery need to find solutions to provide adequate neurosurgical services.
Korean physicians’ bond defies borders Park, Kee B.
Science (American Association for the Advancement of Science),
08/2017, Letnik:
357, Številka:
6353
Journal Article
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.
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.
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.
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.
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