Turkish Neurosurgery 2018 , Vol 28 , Num 3
Effectiveness of Traumatic Brain Injury Management Guideline Introduction in Hungary
Abayomi SORINOLA1,Andras BUKI1,Janos SANDOR4,Endre CZEITER1
1University of Pécs, Department of Neurosurgery, Pécs, Hungary
2University of Pécs, János Szentágothai Research Centre, Pécs, Hungary
3Hungarian Academy of Sciences and University of Pécs, MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
4University of Debrecen, Department of Prevent Medicine, Biostatistics and Epidemiology, Debrecen, Hungary
DOI : 10.5137/1019-5149.JTN.19396-16.1 AIM: To describe the impact of the Traumatic Brain Injury management guideline introduction in Hungary.

MATERIAL and METHODS: Hospital discharge records (HDR) including age, gender, codes of interventions applied, ICD codes of diagnosed disorders of patients admitted between 01/01/2004 and 31/12/2010 with the diagnosis of intracranial injury (S06 by ICD10) from every inpatient institution in Hungary were collected from the database of National Health Insurance Fund (NHIF). The Case Fatality Ratios (CFR) for one week, one month and six months were calculated for the periods before and after the guideline introduction. The change of CFRs was applied as indicators for change of clinical quality elicited by the guideline.

RESULTS: The centers together at one week, one month and six months had pre-guideline introduction CFRs of 23.4%, 37.7% and 47.5% and post-guideline introduction CFRs of 22.1%, 39.1%, and 50.0% respectively. The secondary institutions together at one week, one month and six months had pre-guideline introduction CFRs of 21.5%, 34.8% and 46.3% and post-guideline introduction CFRs of 21.9%, 37.0%, and 48.9% respectively. None of the CFRs showed significant change.

CONCLUSION: The effectiveness of TBI management guideline adaptation in Hungary is poor. Without supportive financing and external auditing system, guideline introduction alone cannot achieve standard clinical practice and a reduction in CFR. Keywords : Case fatality ratio, Guideline, Guideline introduction, Hungary, Traumatic brain injury

Corresponding author : Abayomi SORINOLA, sorinola_abayomi@hotmail.com