A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in haiti

Ernest Joseph Barthélemy, Ernest Benjamin, Marie Yolaine Edouard Jean-Pierre, Geneviève Poitevien, Silvia Ernst, Irene Osborn, Isabelle M. Germano

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objective To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti.

Methods Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome.

Results Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%.

Conclusions This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti.

Original languageEnglish (US)
Pages (from-to)948-953
Number of pages6
JournalWorld Neurosurgery
Volume82
Issue number6
DOIs
Publication statusPublished - Dec 1 2014
Externally publishedYes

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Keywords

  • Brain injuries
  • Cerebrovascular disorders
  • Global health
  • Haiti
  • Neurologic diseases
  • Neurosurgical procedures
  • Outcome assessment

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Barthélemy, E. J., Benjamin, E., Edouard Jean-Pierre, M. Y., Poitevien, G., Ernst, S., Osborn, I., & Germano, I. M. (2014). A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in haiti. World Neurosurgery, 82(6), 948-953. https://doi.org/10.1016/j.wneu.2013.10.012