Delays in Presentation After Traumatic Spinal Cord Injury-A Systematic Review.

Azad, TD; Nair, SK; Kalluri, AL; Materi, J; Ahmed, AK; Khalifeh, J; Abu-Bonsrah, N; Sharwood, LN; Sterner, RC; Brooks, NP; Alomari, S; Musharbash, FN; Mo, K; Lubelski, D; Witham, TF; Theodore, N; Bydon, A

Delays in Presentation After Traumatic Spinal Cord Injury-A Systematic Review.

Azad, TD Nair, SK Kalluri, AL Materi, J Ahmed, AK Khalifeh, J Abu-Bonsrah, N Sharwood, LN Sterner, RC Brooks, NP Alomari, S Musharbash, FN Mo, K Lubelski, D Witham, TF Theodore, N Bydon, A

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Publisher:: ELSEVIER SCIENCE INC
Publication Type:: Journal Article
Citation:: World Neurosurg, 2023, 169, pp. e121-e130
Issue Date:: 2023-01

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Field	Value	Language
dc.contributor.author	Azad, TD
dc.contributor.author	Nair, SK
dc.contributor.author	Kalluri, AL
dc.contributor.author	Materi, J
dc.contributor.author	Ahmed, AK
dc.contributor.author	Khalifeh, J
dc.contributor.author	Abu-Bonsrah, N
dc.contributor.author	Sharwood, LN
dc.contributor.author	Sterner, RC
dc.contributor.author	Brooks, NP
dc.contributor.author	Alomari, S
dc.contributor.author	Musharbash, FN
dc.contributor.author	Mo, K
dc.contributor.author	Lubelski, D
dc.contributor.author	Witham, TF
dc.contributor.author	Theodore, N
dc.contributor.author	Bydon, A
dc.date.accessioned	2023-11-07T03:15:17Z
dc.date.available	2022-10-20
dc.date.available	2023-11-07T03:15:17Z
dc.date.issued	2023-01
dc.identifier.citation	World Neurosurg, 2023, 169, pp. e121-e130
dc.identifier.issn	1878-8750
dc.identifier.issn	1878-8769
dc.identifier.uri	http://hdl.handle.net/10453/173169
dc.description.abstract	BACKGROUND: Prompt surgical decompression after traumatic spinal cord injury (TSCI) may be associated with improved sensorimotor outcomes. Delays in presentation may prevent timely decompression after TSCI. OBJECTIVE: To systematically review existing studies investigating delays in presentation after TSCI in low- and middle-income countries (LMICs) and high-income countries (HICs). METHODS: A systematic review was conducted and studies featuring quantitative or qualitative data on prehospital delays in TSCI presentation were included. Studies lacking quantitative or qualitative data on prehospital delays in TSCI presentation, case reports or series with <5 patients, review articles, or animal studies were excluded from our analysis. RESULTS: After exclusion criteria were applied, 24 studies were retained, most of which were retrospective. Eleven studies were from LMICs and 13 were from HICs. Patients with TSCI in LMICs were younger than those in HICs, and most patients were male in both groups. A greater proportion of patients with TSCI in studies from LMICs presented >24 hours after injury (HIC average proportion, 12.0%; LMIC average proportion, 49.9%; P = 0.01). Financial barriers, lack of patient awareness and education, and prehospital transportation barriers were more often cited as reasons for delays in LMICs than in HICs, with prehospital transportation barriers cited as a reason for delay by every LMIC study included in this review. CONCLUSIONS: Disparities in prehospital infrastructure between HICs and LMICs subject more patients in LMICs to increased delays in presentation to care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCIENCE INC
dc.relation.ispartof	World Neurosurg
dc.relation.isbasedon	10.1016/j.wneu.2022.10.086
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1109 Neurosciences
dc.subject.classification	3202 Clinical sciences
dc.subject.classification	3209 Neurosciences
dc.subject.mesh	Male
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Developing Countries
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Income
dc.subject.mesh	Decompression, Surgical
dc.subject.mesh	Humans
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Decompression, Surgical
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Developing Countries
dc.subject.mesh	Income
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Male
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Developing Countries
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Income
dc.subject.mesh	Decompression, Surgical
dc.title	Delays in Presentation After Traumatic Spinal Cord Injury-A Systematic Review.
dc.type	Journal Article
utslib.citation.volume	169
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1109 Neurosciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Mechanical and Mechatronic Engineering
utslib.copyright.status	closed_access	*
dc.date.updated	2023-11-07T03:15:16Z
pubs.publication-status	Published
pubs.volume	169

Abstract:

BACKGROUND: Prompt surgical decompression after traumatic spinal cord injury (TSCI) may be associated with improved sensorimotor outcomes. Delays in presentation may prevent timely decompression after TSCI. OBJECTIVE: To systematically review existing studies investigating delays in presentation after TSCI in low- and middle-income countries (LMICs) and high-income countries (HICs). METHODS: A systematic review was conducted and studies featuring quantitative or qualitative data on prehospital delays in TSCI presentation were included. Studies lacking quantitative or qualitative data on prehospital delays in TSCI presentation, case reports or series with <5 patients, review articles, or animal studies were excluded from our analysis. RESULTS: After exclusion criteria were applied, 24 studies were retained, most of which were retrospective. Eleven studies were from LMICs and 13 were from HICs. Patients with TSCI in LMICs were younger than those in HICs, and most patients were male in both groups. A greater proportion of patients with TSCI in studies from LMICs presented >24 hours after injury (HIC average proportion, 12.0%; LMIC average proportion, 49.9%; P = 0.01). Financial barriers, lack of patient awareness and education, and prehospital transportation barriers were more often cited as reasons for delays in LMICs than in HICs, with prehospital transportation barriers cited as a reason for delay by every LMIC study included in this review. CONCLUSIONS: Disparities in prehospital infrastructure between HICs and LMICs subject more patients in LMICs to increased delays in presentation to care.

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http://hdl.handle.net/10453/173169