Artikel
Considerations regarding repatriation of patients from a neurosurgical view – lessons learned?
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Veröffentlicht: | 9. Juni 2017 |
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Objective: Repatriation of patients (military and/or civilian) with neurosurgical injuries is a corner stone in the chain of treatment. After initial treatment including stabilization and diagnostics on scene the next step ist to decide on the appropriate further therapy. In our study we wanted to analyse neurosurgical repatriations
Methods: The data of a personal repatriationregister (D. Ritter, M.D.) were analysed. 116 neurosurgical cases were repatriated between 2011 and 2013. These patients were classified in subgroups.In line with a retrospective case-controll-group the data of military and civilian neurosurgical patients - repatriated to the military hospial of Ulm or prepared to repatriation in missions were selected - and the cases descripted.
Results: Summarising the craniocerebral injuries and the spinal injuries in 83 from 116 cases (71,6 %) a trauma diagnosis was underlying. The other diagnosis (disc herniation, tumor, malformation and spontaneous bleeding) were in 33 of 116 cases (28,4 %) not associated with a trauma. From 116 patients only 10 were female (8,6%).
Conclusion: Neurosurgical cases are usually not part of daily practice of repatriation. To determine the best therapeutical procedures adequate expert opinion should be obtained. The decision on the best spectrum and timeline of neurosurgical interventions to be applied and consequently on the optimal timeframe for repatriation to Germany has to be based on a multidisciplinary risk analysis. Therefore, the results of radiological examinations have to be assessed by a neurosurgeon, possibly supported by telemedicine. The increasing risk of infections by multi-resistant bacteria has to be taken into account.