NYMC Faculty Publications

Telemedicine for Neurotrauma Prevents Unnecessary Transfers: An Update from a Nation-Wide Program in Albania and Analysis of 590 Patients

Journal Title

World Neurosurgery

First Page

e340

Last Page

e346

Document Type

Article

Publication Date

August 2019

Department

Surgery

Abstract

BACKGROUND: Telemedicine program in Albania includes a specialized teleneurotrauma program. There is only one national trauma center with neurosurgery capability in the capital city of Tirana. Patients with isolated head or spine injury that require a consultation with neurosurgeons located at the National Trauma Center undergo telemedicine consultation. The aim of this follow-up study is to evaluate the effectiveness of a nation-wide tele-neurotrauma network in preventing unnecessary transfers for neurotrauma. METHODS: We performed a retrospective analysis of prospectively collected data on all telemedicine consultations for isolated neurotrauma from 3/2014 to 2/2018. All teleconsultations were coded using the ICD-10 coding system (ICD-10 codes S00, S01 to S010) RESULTS: Of the 590 teleconsultations for neurotrauma the majority (76%) were male (median age 46.5 years, range 1-93). Of 590, 403 (68.31%), mean age 45.12 years, did not require a transfer to the tertiary center vs. 187 (mean age 42.47 years) that were assigned. An average 12.5 (8.5-16) patients were seen monthly with a steady increase to a mature telemedicine program at the present time. The majority of teleconsultations (70.67%) occurred during business hours (8:00-16:30 hours) and 173 (29.32%) at night and weekends. Analysis by diagnosis indicates that the majority of low-severity cases were not transferred , whereas the higher severity cases were twice as likely to be transferred (p<0.05). CONCLUSION: Structured and coordinated telemedicine for neurotrauma increases access to care for neurosurgery patients in countries that do not have wide-spread neurosurgery services. Nearly 70% of patients may be treated locally by non-neurosuegeons.

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