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Reasons for Delayed Spinal Cord Decompression in Individuals With Traumatic Spinal Cord Injuries in Iran: A Qualitative Study From the Perspective of Neurosurgeons Publisher Pubmed



Sohrabiasl M1 ; Ghodsi Z1 ; Arejan RH1, 2 ; Azadmanjir Z1, 3 ; Sharifalhoseini M1 ; Khormali M1 ; Shojaei M1 ; Rahimiforoushani A4 ; Khoshnevisan A5 ; Vaccaro AR6 ; Fehlings MG7 ; Rahimimovaghar V1, 5, 8, 9, 10, 11
Authors
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Authors Affiliations
  1. 1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Rehabilitation Office, State Welfare Organization of Iran, Tehran, Iran
  3. 3. Health Information Management Department, Tehran University of Medical Sciences
  4. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Orthopaedics and Neurosurgery, Thomas Jefferson University and the Rothman Institute, Philadelphia, PA, United States
  7. 7. Department of Surgery, University of Toronto, Senior Scientist Krembil Brain Institute and McEwen Centre for Regenerative Medicine, Toronto Western Hospital, University Health Network, Canada
  8. 8. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  9. 9. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
  10. 10. Visiting Professor, Spine Program, University of Toronto, Toronto, Canada
  11. 11. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Chinese Journal of Traumatology - English Edition Published:2021


Abstract

Purpose: The median time from the event leading to the spinal cord injury (SCI) to the time of decompressive surgery is estimated to be 6.9 days in Iran, which is much longer than the proposed ideal time (less than 24 h) in published guidelines. The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons. Methods: This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons. Results: The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews. Overall, the type of injury, presence of polytrauma, and surgeons' wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons. Other notable factors include delay in transferring patients to the trauma center, delay in availability of necessary equipment, and scarce medical personnel. Conclusion: In the perspective of neurosurgeons, the type of injury, presence of polytrauma, and surgeons' wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran. © 2021 Chinese Medical Association