Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record

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World Neurosurg


BACKGROUND: The treatment of traumatic brain injury (TBI) in Myanmar is a major health issue. Comprehensive appreciation of the pathology is limited given the lack of granular metadata available. In this proof-of-concept study, we analyzed demographic data on TBI generated from a novel prospective, online database in a low-to-middle income country (LMIC).

METHODS: Neurosurgery residents were given an electronic tablet for data entry onto an online database. Metadata-driven data capture was carried prospectively by the trained residents and the information was reviewed weekly by the supervising team in the United States.

RESULTS: Complete data was available on 242/253 (96%) patients. Age at admission was 37 years (range 16-85) and length of stay was 3.53 days (1-21). Etiologies included motorcycle accidents, falls, assaults, pedestrian vehicular injuries and industrial accidents. Dispositions were primarily to home (211). Average Glasgow Coma Score (GCS) at admission was 12.97. There was a 68% mortality rate of patients directly admitted to NOGH with GCS75% for patients transferred in from other facilities. Surgery was performed on 30 patients (12.4%).

CONCLUSIONS: Despite a lack of formal training in electronic medical records or research, the resident team was able to capture the majority of admissions with granular-level data. This helped shed light on the etiology and severity of TBI in Myanmar. As a result, more effective transport systems and access to trauma care must be achieved. Accessible regional trauma centers with investment in intensive care units, operative care, anesthesia, and imaging resources is necessary.

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ePub ahead of print