We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Adopting and adapting clinical practice guidelines for timing of decompressive surgery in acute spinal cord injury from a developed world context to a developing region.
- Authors
Maroufi, Seyed Farzad; Azadnajafabad, Sina; Pour-Rashidi, Ahmad; Jazayeri, Seyed Behnam; Ghodsi, Zahra; Ghawami, Heshmatollah; Kheyri, Maryam; Farahbakhsh, Farzin; Azarhomayoun, Amir; Bahreini, Maryam; Arab Kheradmand, Jalil; Faghih Jouibari, Morteza; Zareh, Mohammad; Fehlings, Michael G; Rahimi-Movaghar, Vafa
- Abstract
Purpose: The proper application of high-quality clinical practice guidelines improves trauma patients' care and outcomes. This study aimed to adopt and adapt guidelines on the timing of decompressive surgery in acute spinal cord injury (SCI) in Iranian clinical settings. Methods: This study followed a systematic search and review of the literature to enter them into the selection process. The source guidelines' clinical suggestions were converted into clinical scenarios for clinical questions on the timing of decompressive surgery. After summarizing the scenarios, we prepared an initial list of recommendations based on the status of the Iranian patients and the health system. The ultimate conclusion was reached with the help of a national interdisciplinary expert panel comprising 20 experts throughout the country. Results: A total of 408 records were identified. After title and abstract screening, 401 records were excluded, and the full texts of the remaining seven records were reviewed. Based on our screening process, only one guideline included recommendations on the topic of interest. All of the recommendations were accepted by the expert panel with slight changes due to resource availability in Iran. The final two recommendations were the consideration of early surgery (≤24 h) as a treatment option in adult patients with traumatic central cord syndrome and in adult patients with acute SCI regardless of the level of injury. Conclusion: Considering early surgery for adult patients with acute traumatic SCI regardless of the level of injury was the final recommendation for Iran. Although most of the recommendations are adoptable in developing countries, issues with infrastructure and availability of resources are the limitations.
- Subjects
IRAN; SPINAL cord surgery; SPINAL cord injuries; DEVELOPING countries; DECOMPRESSIVE craniectomy; IRANIANS; SURGICAL decompression
- Publication
Acta Neurochirurgica, 2023, Vol 165, Issue 6, p1401
- ISSN
0001-6268
- Publication type
Article
- DOI
10.1007/s00701-023-05591-w