Neurosurgical resident St Paul's Hospital Millenium medical college Addis Ababa, Ethiopia
Introduction: In 2022, we published findings on reported outcomes on thoracolumbar classification in spine trauma patients among neurosurgeons in Africa and North America. We found more similarities in results than expected. However, differences still existed. Most notable was the readmission rate of < 90 days of patients postoperatively in Africa compared to North America. We examined the neurosurgical practices more closely at a single hospital in Ethiopia and compared it to our institution, the University of Missouri in Columbia (UMC).
Methods: Two authors spent one week at Addis Ababa Burn Emergency and Trauma Hospital (AaBeT) in Ethiopia. Throughout the week, one author rotated in the clinic and OR, gathering the information and collecting retrospective data beginning May 2020. Data collection for patients at UMC was collected through retrospective chart review beginning in August 2021
Results: A total of twenty-nine TL spine trauma patients (thoracic, lumbar: burst (2, 13), translation (8,0), distraction (4,2)) at AaBeT and thirty-five patients (thoracic, lumbar: burst (9, 11), translation (3,1), distraction (9,2)) who underwent emergent spinal stabilization procedures UMC were included in the study. Travel time by patients to UMC was an average of 45.9 minutes compared to 3 days and 21 hours at AaBeT. Blood loss was greater at ABeT, with a median blood loss of 400 mL, compared to 250 mL at UMC. The median hospital length of stay was 19 days at ABeT compared to 10 days at UMC, respectively. The readmission rate of < 90 days was 17.1% at UMC, compared to 17.2% at AaBeT.
Conclusion : We found notable differences between neurosurgical practice and patient demographics at AaBeT compared to UMC. This information will be the cornerstone for gathering more information about neurosurgical practice in Ethiopia and North America to improve the quality of care and outcomes in patients with thoracic and lumbar traumatic spine injuries.
