World neurosurgery · 2025
Adherence in Evidence-Based Neurotrauma Guidelines: A Worldwide Survey.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Beraldo Renato Fedatto, Pereira Marcelo Charles, Liebl Bruno, Garg Kanwaljeet, Deora Harsh, Harland Tessa A, Pahwa Bhavya, de Souza Araújo Paulo Victor, Pereira Silvestre Pedro Afonso, Henrique Weiler Ceccato Guilherme, Piedade Guilherme Santos, Demartini Zeferino, Chaurasia Bipin
Аннотация
BACKGROUND: Traumatic brain injury management guidelines vary across regions and there is limited research on real-world adherence to these guidelines. We conducted a global survey to assess the adherence of neurosurgeons to traumatic brain injury guidelines and evidence-based medicine (EBM).
METHODS: A 24-item survey was created using Google Forms, covering demographic information, neurotrauma training, basic knowledge of EBM, and surgical and in-hospital management.
RESULTS: Responses were collected from 233 neurosurgeons across 53 different countries. Approximately 45% of respondents reported not staying up to date with Brain Trauma Foundation guidelines, and 48% indicated a preference for relying on their own experience over EBM guidelines. Neurosurgeons from Asia and Africa were more likely to rely on personal experience, while those from Europe and North/Central and South America leaned toward EBM (P = 0.021). Additionally, 56% of respondents reported that their neurotrauma management at least sometimes diverged from recommended guidelines. Specifically, 58% never or rarely managed epidural hematoma of 30 cm³ conservatively, and 45% sometimes, often, or always treated subdural hematomas conservatively, even when EBM recommended surgery. Moreover, 24% at least sometimes managed patients conservatively despite a Glasgow Coma Scale score of less than 9 or a decrease of 2 or more points. In cerebellar hematomas, 46% sometimes opted for external ventricular drainage alone.
CONCLUSIONS: Neurosurgeons from Europe and North/Central and South America tend to follow EBM guidelines more closely, while those from Asia and Africa often favor individual decision-making approaches.
METHODS: A 24-item survey was created using Google Forms, covering demographic information, neurotrauma training, basic knowledge of EBM, and surgical and in-hospital management.
RESULTS: Responses were collected from 233 neurosurgeons across 53 different countries. Approximately 45% of respondents reported not staying up to date with Brain Trauma Foundation guidelines, and 48% indicated a preference for relying on their own experience over EBM guidelines. Neurosurgeons from Asia and Africa were more likely to rely on personal experience, while those from Europe and North/Central and South America leaned toward EBM (P = 0.021). Additionally, 56% of respondents reported that their neurotrauma management at least sometimes diverged from recommended guidelines. Specifically, 58% never or rarely managed epidural hematoma of 30 cm³ conservatively, and 45% sometimes, often, or always treated subdural hematomas conservatively, even when EBM recommended surgery. Moreover, 24% at least sometimes managed patients conservatively despite a Glasgow Coma Scale score of less than 9 or a decrease of 2 or more points. In cerebellar hematomas, 46% sometimes opted for external ventricular drainage alone.
CONCLUSIONS: Neurosurgeons from Europe and North/Central and South America tend to follow EBM guidelines more closely, while those from Asia and Africa often favor individual decision-making approaches.