Neurosurgical Emergencies in the Amazon: An Epidemiologic Study of Patients Referred by Air Transport for Neurosurgical Evaluation at a Referral Center in Amazonas

Abstract

Amazonas is the largest state in Brazil, covering an area of 1,559,159.148 km2 and primarily occupied by the Amazon rainforest. Fluvial and aerial transport are the primary means of transportation. Studying the epidemiologic profile of patients transported by neurologic emergencies is essential because there is only 1 referral center hospital serving approximately 4 million inhabitants in Amazonas. This work studies the epidemiologic profile of patients referred by air transport for evaluation by the neurosurgery team at a referral center in the Amazon. Of the 68 patients transferred, 50 (75.53%) were men. The study covered 15 municipalities in Amazonas. Of the patients, 67.64% had a traumatic brain injury due to various causes, and 22.05% had had a stroke. Of all patients, 67.65% did not undergo surgery and 43.9% evolved with good evolution and without complications. Air transportation for neurologic evaluation is essential in Amazonas. However, most patients did not require neurosurgical intervention, indicating that investments in medical infrastructures, such as computed tomography scanners and telemedicine, may optimize health costs.