Neurosurgical care in cerebrovascular diseases in Ukraine. Analysis of statistical data of neurosurgical service

Abstract

Objective. Evaluate the provision of the neurosurgical care to the patients with the cerebrovascular diseases (CVD) in Ukraine and determine the ways of its improvement. Materials and methods. The analysis has been performed based on the statistical data regarding the clinical care in the departments of neurosurgery in Ukraine within 2006-2015 years. The statistical methods of sampling and grouping and statistical series studies have been used. Calculations have been performed using Microsoft Office Excel. Results. The number of the patients with CVD who were hospitalized into national departments of neurosurgery increased by 76% (from 143 patients with CVD per 1 million of population — in 2006 up to 252 — in 2015) over the past decade. In 2015, 119 patients with CVD per 1 million had surgeries; it is 2.3-fold higher than in 2006 (51). The proportion of hospitalized patients with CVD increased from 7 to 10% within 10 years, surgically operated patients — from 6 to 11%. The surgical activity increased from 36% — in 2006 to 47.4% — in 2015 (rate of increase: 32%). The rate of mortality was decreased: total — from 10.5 to 8.9% (rate of decrease: 15%), post-surgical — from 16.9 to 8.9% (rate of decrease: 47%). Kiev is the leader of the neurosurgical care provision to the patients with CVD based on the absolute values. In 2015, 4173 patients with CVD (46% of all patients in Ukraine — 9146) were hospitalized into the departments of neurosurgery in the capital city; 2177 surgical interventions (50% of all patients who underwent surgeries in the country — 4336) were performed. In 2015, Ivano-Frankovsk (17.9%), Dnepropetrovsk (16.2%), Lvov (12.1%) regions provided the most neurosurgical care in CVD; in 8 regions the provision index was 5-10%; in 10 regions it was less than 5%. No neurosurgical care was provided to the patients with CVD in Sumy region. Overall, the provision index of the neurosurgical care in CVD in Ukraine was 13.3%. Conclusions. The number of patients with CVD who received the specialized neurosurgical care increased more than double within 10 years. Significant increase in the surgical activity and decrease of the total and post-surgical mortality has been observed. The levels of the neurosurgical care provision to the patients with CVD significantly differ in the regions. Low level of meeting the demands in the neurosurgical care provision to the patients with CVD is observed with the significant ranges of values in the regions of Ukraine. It is necessary establish 7-9 neurosurgical inter-regional excellence centers. It is worth to prepare and implement the state program of countermeasures in CVD.