Abstract Details

Title The Role of Electronic Medical Records in Enhancing Protocol Adherence and Outcomes for Traumatic Brain Injury in Low- and Middle-income Countries: A Systematic Review of Neurocritical Care Management

Topic Neuro Trauma and Critical Care

Presentation(s) P10 - Poster Session 10 (5:00 PM-6:00 PM)

Poster/Presentation
Number 7-007

Objective This systematic review evaluates the role of Electronic Medical Records (EMR) in enhancing evidence-based protocols and improving the prognosis for traumatic brain injury (TBI) patients in low- and middle-income countries (LMICs).

Background TBI is a leading global cause of morbidity and mortality, disproportionately affecting LMICs. Prehospital care and timely emergency department interventions are crucial, yet LMICs often lack standardized treatment guidelines, EMR systems, and reliable internet infrastructure. This systematic review applies Haddon’s Matrix to examine post-injury interventions, evaluating how evidence-based protocols can reduce variability in care delivery and improve patient outcomes.

Design/Methods A dual-phase systematic review was conducted using PRISMA 2020 guidelines. Phase I evaluated (n=33) studies conducted at LMIC hospital systems, focusing on clinical decision-making and patient outcomes. These studies informed Phase II (n=26), which assessed EMR capacity and treatment guidelines by region, allowing for integrated data analysis. Descriptive statistics, chi-square (x²) tests, ANOVA, and multiple linear regression (MLR) assessed the relationship between EMR presence and outcomes.

Results Presence of EMR infrastructure demonstrated significant improvement in clinical outcomes, accounting for 36.5% of the variance in patient morbidity (p=0.0328, R²=0.3649). In regions with established EMR systems, ANOVA revealed a 12.17% morbidity reduction (F=4.7354, p=0.0328). Chi-square analysis showed strong associations between EMR presence and adherence to neurocritical care protocols, including airway management (p=0.0277, x²=4.72) and cervical spine immobilization (p<0.0001, x²=19.67). Low-EMR regions exhibited significant underutilization of computed tomography (CT) imaging (p=0.0142, x²=6.03) and seizure prophylaxis (p=0.0557, x²=3.78). Adherence to interventions led to a 16.73% improvement in patient survival (p=0.0222), with EMR presence contributing 46% to overall reduction in traumatic brain injury (TBI) mortality (R²=0.598, p=0.0282).

Conclusions EMR infrastructure strengthens neurocritical care interventions and leads to improved clinical outcomes in LMICs. These findings emphasize the need for global initiatives to prioritize EMR implementation and adopt evidence-based standards of care to reduce healthcare disparities in resource-limited settings.

Authors/Disclosures
Jacob J. Shawwa PRESENTER	Mr. Shawwa has nothing to disclose.
Caleigh S. Roach	Miss Roach has nothing to disclose.
Matthew A. Kis, BS	Mr. Kis has nothing to disclose.
Mikhail Marasigan	Mr. Marasigan has nothing to disclose.
Eugenio Reina	Mr. Reina has nothing to disclose.
Brett Weiss	Mr. Weiss has nothing to disclose.
Ansh J. Bhatt, MD/MBA Student	Mr. Bhatt has nothing to disclose.
Alan Ho, BA	Mr. Ho has received personal compensation for serving as an employee of Neurobit Innovations.
Harini Adivikolanu	Ms. Adivikolanu has received personal compensation for serving as an employee of RegenMed LLC.
Joyce Kaufman, MD	Dr. Kaufman has nothing to disclose.

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