• Jack P Rock, Tyler Prentiss, Su Myat Mo, Nang Saw Myat Hnin Aye, Karam Asmaro, Aung Thurein Win, Aye Mya Phyu, Thint Myat, Thet Maung Maung, Ai Ai Khaing, Zayya Naung, Kee B Park, Kyi Hlaing, and Win Myaing.
• Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA. Electronic address: jrock1@hfhs.org.
• World Neurosurg. 2020 Aug 1; 140: e260-e265.

BackgroundThe treatment of traumatic brain injury (TBI) in Myanmar is a major health issue. Comprehensive appreciation of the pathology is limited given the lack of granular metadata available. In this proof-of-concept study, we analyzed demographic data on TBI generated from a novel, prospective, online database in a lower-middle income country.MethodsNeurosurgery residents were given an electronic tablet for data entry into an online database. Metadata-driven data capture was carried out prospectively by trained residents, and the information was reviewed weekly by the supervising team in the United States.ResultsComplete data were available on 242/253 (96%) patients. Age at admission was 37 years (range 16-85), and length of stay was 3.53 days (1-21). Etiologies included motorcycle accidents, falls, assaults, pedestrian vehicular injuries, and industrial accidents. Dispositions were primarily to home (211). Average Glasgow Coma Scale score at admission was 12.97. There was a 68% mortality rate of patients directly admitted to the North Okkalappa General and Teaching Hospital with a Glasgow Coma Scale score <8 versus 75% for patients transferred in from other facilities. Surgery was performed on 30 patients (12.4%).ConclusionsDespite a lack of formal training in electronic medical records or research, the resident team was able to capture the majority of admissions with granular-level data. This helped shed light on the etiology and severity of TBI in Myanmar. As a result, more effective transport systems and access to trauma care must be achieved. Accessible regional trauma centers with investment in intensive care units, operative care, anesthesia, and imaging resources are necessary.Copyright © 2020 Elsevier Inc. All rights reserved.

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