title: A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in Haiti.
abstract: OBJECTIVE
  To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti.
  
  
  METHODS
  Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome.
  
  
  RESULTS
  Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%.
  
  
  CONCLUSIONS
  This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti.
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Ernest Joseph
authors.initials: EJ
authors.lastname: Barthélemy
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Ernest
authors.initials: E
authors.lastname: Benjamin
authors.affiliation: Département de Chirurgie, Hôpital de L'Université d'État d'Haïti, Port-au-Prince, Haiti; Pôle de Recherche en Chirurgie, Faculté des Sciences de la Santé, Université Quisqueya, Port-au-Prince, Haiti.
authors.forename: Marie Yolaine
authors.initials: MY
authors.lastname: Edouard Jean-Pierre
authors.affiliation: Pôle de Recherche en Chirurgie, Faculté des Sciences de la Santé, Université Quisqueya, Port-au-Prince, Haiti.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Poitevien
authors.affiliation: Hôpital Albert Schweitzer, Deschapelles, Haiti.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ernst
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Osborn
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: isabelle.germano@mountsinai.org.
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Germano
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D019538:Health Care Surveys; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000145:classification / Q000453:epidemiology* / Q000601:surgery*; D009493:Neurosurgery / Q000706:statistics & numerical data / Q000639:trends*; D015995:Prevalence; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Brain injuries; Cerebrovascular disorders; Global health; Haiti; Neurologic diseases; Neurosurgical procedures; Outcome assessment