Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record
Rock JP, Prentiss T, Mo SM, Myat Hnin Aye NS, Asmaro K, Win AT, Phyu AM, Maung TM, Khaing EE, Naung Z, Park KB, Hlaing K, and Myaing W. Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record. World Neurosurg 2020.
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.
ePub ahead of print