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05:01
A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
7.5K
Neurosurgical workload during US combat operations: 2002 to 2016.
Caryn A Turner1, Zsolt T Stockinger, Randy S Bell
1From the Joint Trauma System (C.A.T., Z.T.S., J.M.G.), Fort Sam Houston, Texas; Walter Reed National Military Medical Center (R.S.B.), Bethesda, Maryland.
The Journal of Trauma and Acute Care Surgery
|July 3, 2018
Summary
Military general surgeons require trauma neurosurgery training as neurosurgical procedures are common in combat zones. This study analyzed 7,509 neurosurgical procedures in Iraq and Afghanistan to inform training needs.
Area of Science:
- Military medicine
- Surgical outcomes
- Trauma surgery
Background:
- Neurosurgical procedures constitute approximately 4.5% of surgeries at Role 2 (forward) and Role 3 (theater) facilities.
- These procedures are outside the routine scope of military general surgeons.
Purpose of the Study:
- To analyze the neurosurgical workload in Iraq and Afghanistan.
- To inform predeployment neurosurgical training requirements for non-neurosurgical providers.
Main Methods:
- Retrospective analysis of the Department of Defense Trauma Registry (January 2002–May 2016).
- Identification and categorization of 103 neurosurgical procedure codes by anatomic location.
- Data analysis using Stata version 14.
Main Results:
- A total of 7,509 neurosurgical procedures were identified, with 96.5% performed at Role 3 facilities.
- Cranial procedures were most common (45.3% at R2, 61.9% at R3), primarily craniotomies/craniectomies.
- Spine procedures were mainly fusions/stabilizations (61.1%) and decompressions (26.9%) at R3.
Conclusions:
- Neurosurgical procedures predominantly occurred at Role 3 hospitals, but over 100 cranial procedures were done at Role 2 facilities.
- Given the uneven availability of neurosurgeons, general surgeons deployed to combat zones need familiarity with trauma neurosurgery.
- Training general surgeons in trauma neurosurgery is essential for forward surgical units.
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