gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Considerations regarding repatriation of patients from a neurosurgical view – lessons learned?

Meeting Abstract

  • Gregor Freude - Neurochirurgische Klinik, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
  • Chris Schulz - Ulm, Deutschland
  • Uwe Mauer - BWK Ulm, Abt. NCHIR, Postfach, Ulm, Deutschland
  • Ulrich Kunz - Ulm, Deutschland
  • Dennis Ritter - Koblenz, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.17.08

doi: 10.3205/17dgnc104, urn:nbn:de:0183-17dgnc1040

Published: June 9, 2017

© 2017 Freude et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

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.