Temporal Delays Along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients at a Tertiary Care Hospital in Kampala, Uganda

Neurosurgery
Silvia D VacaMichael M Haglund

Abstract

Significant care continuum delays between acute traumatic brain injury (TBI) and definitive surgery are associated with poor outcomes. Use of the "3 delays" model to evaluate TBI outcomes in low- and middle-income countries has not been performed. To describe the care continuum, using the 3 delays framework, and its association with TBI patient outcomes in Kampala, Uganda. Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June to 30 November 2016. Four time intervals were constructed along 5 time points: injury, hospital arrival, neurosurgical evaluation, computed tomography (CT) results, and definitive surgery. Time interval differences among mild, moderate, and severe TBI and their association with mortality were analyzed. Significant care continuum differences were observed for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 h for interval 3 and 24 h for interval 4) and mild TBI patients (19 h for interval 3 and 96 h for interval 4). These postarrival delays were associated with mortality for mild (P = .05) and moderate TBI (P = .03) patients. Significant hospital arrival delays for moderate TBI patients were...Continue Reading

References

Jan 1, 1988·Acta neurochirurgica·K HaselsbergerL M Auer
Jul 1, 1968·Journal of Neurosurgery·K G Jamieson, J D Yelland
Jul 1, 1968·Journal of Neurosurgery·J P Gallagher, E J Browder
Oct 15, 1981·The New England Journal of Medicine·W H ClewellD O'Keeffe
Apr 1, 1994·Social Science & Medicine·S Thaddeus, D Maine
May 23, 2006·Neurosurgery·M Ross BullockUNKNOWN Surgical Management of Traumatic Brain Injury Author Group
Sep 11, 2008·International Journal of Epidemiology·Mary J De SilvaUNKNOWN CRASH Trial Collaborators
Jun 24, 2010·Epidemiologic Reviews·Aruna ChandranCorinne Peek-Asa
Apr 20, 2013·American Journal of Public Health·Marie CrandallThomas Esposito
Feb 18, 2014·Journal of Neurosurgery. Spine·Jared D AmentRichard Moser
Apr 11, 2014·BMC Pregnancy and Childbirth·Tesfay GebrehiwotIsabel Goicolea
Sep 11, 2014·World Neurosurgery·Jude Kennedy C EmejuluEzekiel Uche Nwankwo
Jan 2, 2016·Journal of Neurosurgery·Judith MarcouxRajeet S Saluja
Jul 14, 2016·World Journal of Surgery·Hani MowafiPhil Seidenberg
Aug 24, 2017·International Journal for Equity in Health·Thiago Augusto Hernandes RochaLuiz Augusto Facchini

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Citations

Nov 30, 2018·Journal of Neurosurgery. Pediatrics·Silvia D VacaGerald Grant
Jan 20, 2019·Journal of Neurosurgery·Saksham GuptaKee B Park
Mar 23, 2019·Trauma Surgery & Acute Care Open·Nukhba ZiaAdnan A Hyder
Oct 27, 2020·Annals of Global Health·Chinemerem NwosuAnthony Fuller
Mar 20, 2021·Risk Management and Healthcare Policy·Eka BurkadzeCorinne Peek-Asa
Sep 15, 2021·World Neurosurgery·Gideon AdegboyegaAndrew Folusho Alalade
May 11, 2019·Journal of Neurosurgery·Thiago Augusto Hernandes RochaJoao Ricardo Nickenig Vissoci

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Brain Injury & Trauma

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