Teleneurosurgery: Mild Head Injury Outcomes in Johor's Non-Neurosurgical Centre

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: Teleneurosurgery: Outcome of Mild Head Injury Patients Managed in Non-Neurosurgical Centre in the State of Johor
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Mohd Syahiran Mohd Sidek, Johari Adnan Siregar, Abdul Rahman Izani Ghani, Zamzuri Idris


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Teleneurosurgery: Outcome of Mild Head Injury Patients Managed in Non-Neurosurgical Centre in the State of Johor

Year: 2018 | Doi: 10.21315/mjms2018.25.2.10

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

In Malaysia, neurosurgical services are limited, necessitating the use of telemedicine, specifically teleneurosurgery, for managing head injuries in facilities without dedicated neurosurgical teams. This study evaluates the outcomes for patients with mild head injuries treated in non-neurosurgical centers in Johor state, utilizing teleneurosurgery for expert consultations. It emphasizes the growing reliance on remote support in medical practice, particularly for managing traumatic brain injuries.

Importance of Teleneurosurgery in Patient Management

The implementation of teleneurosurgery in managing mild head injury cases has proven advantageous by allowing many patients to receive necessary care in primary hospitals, thereby avoiding unnecessary transfers. This study assessed outcomes in 359 patients, observing a high rate of favorable results, with only 3.06% of patients experiencing unfavorable outcomes. These outcomes were primarily linked to delayed transfers for surgical interventions. The study also highlighted the lack of significant differences in the Glasgow Outcome Scale across various demographics, although Malay ethnicity and GCS at referral were noted as factors influencing patient outcomes.

Conclusion

The findings from this study indicate that teleneurosurgery is an effective model for managing mild head injuries in non-neurosurgical settings, thus reducing transfer rates and associated costs. The low percentage of unfavorable outcomes suggests that this practice is both safe and economical. However, the study's limitations due to sample size require further investigation with larger cohorts to confirm these findings and enhance our understanding of the effectiveness of teleneurosurgery in diverse clinical settings.

FAQ section (important questions/answers):

What is the focus of this teleneurosurgery study?

The study evaluates the outcomes of mild head injury patients managed in non-neurosurgical centers in Johor State, Malaysia, using teleneurosurgery for remote consultations with a centralized neurosurgical team.

How many patients were included in the study?

A total of 359 patients with mild head injury were included in the study, with 11 patients recorded as having an unfavorable outcome, representing 3.06% of the sample.

What were the main findings concerning patient outcomes?

The study found no significant factors affecting the outcome of mild head injury patients. Most patients had a favorable outcome, with 96.94% being discharged with stable or improved Glasgow Coma Scale scores.

What limitations were present in the study?

The primary limitation was the small sample size in the unfavorable outcome group. Future recommendations include conducting a larger, multicentric study to better assess the effectiveness of teleneurosurgery in managing mild head injuries.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Teleneurosurgery: Mild Head Injury Outcomes in Johor's Non-Neurosurgical Centre”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In the context of clinical research, a 'Table' presents organized data for easy interpretation. For instance, Table 1 outlines patient assessment criteria, showcasing critical outcomes and statistical correlations. Proper design and clarity in tables ensure effective communication of findings, critical for drawing conclusions that influence medical practices and policies.

2) Study (Studying):
A 'Study' represents systematic investigations aiming to evaluate hypotheses or investigate phenomena. In this context, the study assesses the outcomes of mild head injuries managed via teleneurosurgery. It provides insights into treatment efficacy, contributing to evidence-based practices that enhance patient care and optimize health outcomes.

3) Death:
'Death' is a crucial endpoint in medical research, often indicating treatment failure or complications. In this case, the study mentions recorded deaths post-neurosurgical interventions to highlight the risks associated with head injuries. Understanding mortality rates aids in improving clinical protocols and ensuring better patient prognostication.

4) Coma:
'Coma' refers to a state of prolonged unconsciousness, commonly assessed by the Glasgow Coma Scale (GCS). This metric is vital for gauging the severity of brain injuries. The study utilizes GCS scores to classify patient outcomes, linking them to treatment efficacy, indicating the severity of cases managed in the study.

5) Rules:
'Rules' often dictate clinical guidelines and protocols in medical practice. In this study, adherence to established rules, such as the Canadian CT Head Rule, is essential for patient safety. These rules guide clinical decision-making, ensuring that patients are assessed accurately for potential intracranial injuries, thereby improving care outcomes.

6) Male:
'Male' gender is a demographic variable often analyzed in studies assessing health outcomes. The study presents data indicating the majority of participants were male. Understanding gender differences in outcomes from head injury management aids in tailoring treatment approaches, ensuring that care reflects the specific needs of diverse patient populations.

7) Patel:
'Patel' identifies an author referenced in the study related to management outcomes of head injuries. Citing previous work enriches the depth of discussion, providing context to findings. This citation highlights established research that shapes current clinical practices, enhancing the credibility of the study’s claims and conclusions.

8) King:
'King' refers to another researcher involved in the referenced studies. Including multiple authors emphasizes collaboration in medical research. Their collective work contributes to the field, showcasing the importance of shared knowledge in advancing understanding of effective treatments and outcomes for patients suffering from head injuries.

9) Sign:
'Sign' in medical terms often refers to a clinical observation or indicator of a patient's health condition. In this study, significant outcomes, as highlighted through statistical analysis (P-values), help to determine the relationship between variables like GCS and recovery rates, guiding future clinical practices in trauma management.

10) Post:
'Post' typically refers to the period after an event; in medical research, it may indicate follow-up assessments or outcomes. This study examines patient conditions post-intervention at intervals of 3 and 6 months to evaluate recovery effectiveness, providing insights into long-term effects of treatment and management strategies.

11) Pur:
'Poor' often describes unfavorable health outcomes or conditions. In the context of this research, it may refer to low optimism in patient prognoses related to severe injuries. Recognizing patients with poor outcomes informs clinicians on the need for intensified monitoring and alternative treatment approaches to improve recovery.

12) Transmission:
'Transmission' in a medical context pertains to the transfer of information, such as clinical data or imaging, vital for remote consultations. This study utilizes teleneurosurgery, where timely and accurate transmission of patient information between hospitals is critical, ensuring effective decision-making and management of mild head injuries.

13) Discussion:
'Discussion' sections in research papers synthesize findings, allowing authors to interpret results, contextualize their significance, and suggest implications and future directions. In this study, the discussion illuminates clinical implications of managing head injuries via teleneurosurgery, connecting study results to broader issues within trauma care and patient management.

14) Attending:
'Attending' generally refers to the designated physician supervising patient care. In this study, attending medical officers effectuate the follow-up assessments, ensuring adherence to clinical guidelines and consistency in patient evaluations. Their role is pivotal in interpreting Glasgow Outcome Scale results, shaping patient management decisions post-injury.

15) Medicine:
'Medicine' encompasses the science and practice of diagnosing, treating, and preventing diseases. This study emphasizes advancements in medical practice, particularly through the use of teleneurosurgery in managing head injuries. Progress in medicine is reflected in methods that enhance patient outcomes, shaping future healthcare practices and protocols.

16) Quality:
'Quality' in healthcare refers to the standard of care delivered to patients. Assessing the quality of outcomes in this study is essential, as it evaluates the effectiveness of remote neurosurgical consultations. Ensuring high-quality care through innovative methods like teleneurosurgery can lead to improved patient outcomes and satisfaction.

17) Indian:
'Indian' signifies a demographic group within the study's population. It enriches the demographic diversity of participants, providing insights into varying health outcomes among different ethnicities. Understanding the implications of ethnicity in health outcomes helps tailor treatment protocols that respect cultural diversities in healthcare settings.

18) Kar:
'Kaar' is mentioned as part of the authorship in the referenced studies, highlighting contributions in the literature regarding trauma management. Inclusion of diverse authors fosters a comprehensive understanding of the subject, enriching the discussion with varied experiences and expertise, crucial for advancing research in neurosurgical treatment.

19) Observation:
'Observation' refers to the act of carefully monitoring patients or collecting data in clinical settings. In this study, observations made during follow-ups are critical for evaluating the effectiveness of head injury management through teleneurosurgery, providing a foundation upon which further medical decisions can be based.

20) Practising (Practicing):
'Practicing' denotes the application of medical knowledge in real-world settings. This study evaluates the effectiveness of teleneurosurgery practices in managing head injuries at non-neurosurgical centers, demonstrating the practical implications of remote consultations aimed at improving patient outcomes and enhancing the overall quality of emergency care.

21) Vomiting:
'Vomiting' is a clinical symptom that can indicate underlying issues, such as increased intracranial pressure in head injury patients. Evaluating symptoms like vomiting is vital for assessing patient conditions and determining management pathways. Recognizing critical symptoms leads to timely interventions and improved outcomes in medical practice.

22) Science (Scientific):
'Science' encompasses the systematic study of phenomena, foundational to research in medicine. This study exemplifies the application of scientific methods to evaluate teleneurosurgery's effectiveness, contributing to the body of knowledge aimed at improving trauma care. Rigorous scientific inquiry ensures evidence-based practices in patient management and treatment protocols.

23) Reason:
'Reason' often refers to justifications for actions or decisions in clinical contexts. This study provides rationale for utilizing teleneurosurgery as an effective alternative for managing head injury patients. Clearly outlining the reasons behind treatment decisions helps establish credibility and understanding of care approaches among healthcare professionals.

24) Medium:
'Medium' denotes an intermediate state or quality. In the context of the study, 'medium risk' relates to patients with potential complications from mild head injuries, evaluating their management and treatment pathways. Identifying medium-risk patients is crucial for ensuring appropriate care levels and follow-up strategies to prevent adverse outcomes.

25) Gold (Golden):
'Gold' typically refers to the highest standard or benchmark in medical assessments. The Glasgow Coma Scale (GCS) is considered the 'gold standard' for evaluating consciousness in head injury patients. Establishing benchmarks like GCS allows for consistent patient assessments, critical in formulating effective treatment strategies and improving care outcomes.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Teleneurosurgery: Mild Head Injury Outcomes in Johor's Non-Neurosurgical Centre’. Further sources in the context of Science might help you critically compare this page with similair documents:

Surgical intervention, Statistical analysis, Sample size, Ethical committee, Study population, Small sample size, Subarachnoid hemorrhage, Head injury, Glasgow Coma Scale Score, Computerized tomography, Subdural hemorrhage, Univariate logistic regression analysis, Traumatic brain injury, GC, Severe head injury, Favourable outcome, Subdural hematoma, Future study, Mass effect, Global impact, Major trauma, Motor vehicle accident.

Concepts being referred in other categories, contexts and sources.

Go, Timely manner, Failure.

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