Improving the system of neurotraumatology care in the metropolis for elderly victims with severe traumatic brain injury (on the example of Saint Petersburg)

Abstract

The OBJECTIVE was to study the dependence of the results of neurosurgical treatment of elderly patients with severe TBI on the organizational transformations of the neurotraumatology care system on the metropolis – Saint Petersburg scale.METHODS AND MATERIALS. 1228 victims aged 60 to 75 years with severe TBI (men – 982 (80.0 %) people, women – 246 (20.0 %) people) who were treated in the neurotraumatology centers of St. Petersburg in the period before (2007–2009) and after (2010–2020) organizational transformations.RESULTS. The measures implemented on a megalopolis scale have made it possible to improve the system of neurotraumatology care in St. Petersburg due to optimal routing and rapid delivery of elderly victims with severe TBI to neurotraumatology centers, performing brain SCT scans around the clock during the first 6 hours from the moment of their delivery to the hospital, conducting minimally invasive including neuroendoscopic brain surgery, performing early rehabilitation treatment in the conditions of neurotraumatology centers with further continuation in inpatient centers and medical rehabilitation departments.CONCLUSION. Modernization of the system of neurotraumatology care for elderly patients with severe TBI on the metropolis – St. Petersburg scale allowed to reduce the frequency of functional disorders, infectious and inflammatory complications, the rate of temporary disability, disability and mortality of victims.

Keywords

• traumatic brain injury
• infectious and inflammatory complications
• old age