A 3-Country Assessment of Traumatic Brain Injury Practices and Capacity.
A 3-Country Assessment of Traumatic Brain Injury Practices and Capacity.
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DOI：
10.1016/j.wneu.2020.10.115
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发表时间：
2021-03
影响因子：
2
通讯作者：
Peek-Asa C
中科院分区：
文献类型：
--
作者：
Dulf D;Coman MA;Tadevosyan A;Chikhladze N;Cebanu S;Peek-Asa C
世界卫生组织预测，在未来几十年中，创伤性脑损伤（TBI）的负担将显著增加。预计低收入和中等收入国家的脑损伤率将不成比例地大幅增加，这些国家的脑损伤率是高收入国家的三倍。这项研究的目的是确定目前的创伤性脑损伤的做法和治疗能力在三个低收入国家：亚美尼亚共和国，格鲁吉亚和摩尔多瓦共和国。在对治疗创伤性脑损伤的医院进行全国盘点后，在每个国家容量最大的成人和儿科医院进行了情况分析。情境分析包括与内容分析和治疗资源的定量清单的关键线人访谈。这三个国家都遵循国际、国家和医院的创伤性脑损伤治疗方案，创伤性脑损伤患者的院内管理与这三个国家的国际标准相似。尽管保健专家受过良好的培训，但在对所有三个国家的访谈中都提到缺乏适当的设备、首都地区以外的医院数量很少、地区缺乏专业人员以及缺乏康复服务。在入院前护理和康复护理以及国家领导和数据收集方面发现了特别的差距。监测和标准化数据收集是填补治疗空白和减轻TBI负担的重要措施。
The World Health Organization predicts a striking rise in the burden of traumatic brain injury (TBI) burden in the next decades. A disproportionately large increase is predicted in low and middle income countries, which have brain injury rates three times higher than high income countries. The aim of this study was to identify current TBI practices and treatment capacity in three LMICs: Republic of Armenia, Georgia and Republic of Moldova. After a national inventory of hospitals treating TBI, a situational analysis was conducted in the highest volume adult and pediatric hospital in each country. The situational analysis included key informant interviews with content analysis and a quantitative checklist of treatment resources. All three countries follow international, national and hospital protocols for TBI treatment, and the in –hospital management of patients with TBI is similar to international standards in all three countries. Although healthcare specialists were well trained, however, lack of proper equipment, a scant number of hospitals outside the capital region, lack of specialized personnel in regional areas and lack of rehabilitation services were mentioned in interviews from all three countries. Particular gaps were found in pre-hospital and rehabilitative care, as well as national leadership and data collection. Surveillance and standardized data collection are important measures to fill treatment gaps and reduce the burden of TBI.
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