Europe [Neurosurgery Wiki]

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====== Europe ======

Europe is a diverse continent with a population of nearly 750 million living in over 40 countries.[[ Healthcare]] in Europe is provided by a wide range of systems run at national levels with a state-run system being the prevailing model. Specialist [[training]] in neurosurgery varies across the continent. In many countries, entry into a specialist training programme is a competitive process that follows award of a medical degree. In other countries, foundation (internship) and basic surgical experience is first required, providing a platform for further learning. The duration of training varies and there is no unifying curriculum. The requirements for certification, or licensing, differ from one country to another and there are variations in the levels of operative experience between trainees
((Stienen M.N., Freyschlag C.F., Schaller K. Meling T for EANS Young neurosurgeons and EANS training committee. Acta Neurochir. 2020;162:2303–2311. ))
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Considering the European centers, recent [[survey]]s among [[neurosurgical resident]]s report very low [[satisfaction]] rates for the theoretical and practical aspects of [[training]] in some countries
((Stienen MN, Netuka D, Demetriades AK, Ringel F, Gautschi OP, Gempt J, et al. Neurosurgical resident education in Europe—results of a multinational survey. Acta Neurochir. (2016) 158(1):3–15. 10.1007/s00701-015-2632-0))

Another [[survey]] demonstrated a large variation in the number of [[critical care]] [[bed]]s across countries. Moreover, no clear central policies to facilitate [[planning]] to meet the demand and optimal utilization in the future exist
((Rhodes A, Ferdinande P, Flaatten H, et al.: The variability of [[critical care]] bed numbers in
Europe. Intensive care medicine 38:1647-1653, 2012)).

===== History =====

see [[Neurosurgery History in Europe]].

===== Hospitals =====

[[Austria]]

[[Belgium]]

[[Bulgaria]]	

[[Croatia]]

[[Cyprus]]	

[[Czech Republic]]	

[[Denmark]]

[[Estonia]]

[[Finland]]

[[France]]

[[Germany]]

[[Greece]]

[[Hungary]]

[[Ireland]]	

[[Italy]]

[[Latvia]]

[[Lithuania]]

[[Luxembourg]]

[[Malta]]

[[Netherlands]]

[[Poland]]

[[Portugal]]

[[Romania]]

[[Slovakia]]

[[Slovenia]]

[[Spain]]

[[Sweden]]

[[United Kingdom]]


===== Societies =====

see [[European Association of Neurosurgical Societies]].

see [[European Board Examination in Neurosurgery]].

===== Neurosurgical training =====

see [[Neurosurgical Training in Europe]]
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The aim of study was to describe current approaches and to quantify variability between [[Europe]]an [[intensive care unit]]s (ICU)s in patients with [[traumatic brain injury]] (TBI). Therefore, Huijben et al. conducted a provider profiling [[survey]] as part of the 'Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury' (CENTER-TBI) study. The ICU Questionnaire was sent to 68 centers from 20 countries across Europe and [[Israel]]. For this study, they used ICU questions focused on 1) [[hemoglobin]] target level (Hb-TL), 2) coagulation management, and 3) [[deep venous thrombosis]] (DVT) prophylaxis. Sixty-six centers completed the ICU questionnaire. For ICU-patients, half of the centers (N= 34; 52%) had a defined Hb-TL in their protocol. For patients with TBI, 26 centers (41%) indicated a Hb-TL between 70 and 90 g/l and 38 centers (59%) above 90 g/l. To treat trauma related hemostatic abnormalities the use of [[fresh frozen plasma]] (N= 48; 73%) or [[platelet]]s (N= 34; 52%) was most often reported, followed by the supplementation of [[vitamin K]] (N= 26; 39%). Most centers reported using DVT prophylaxis with [[anticoagulant]]s frequently or always (N= 62; 94%). In the absence of hemorrhagic brain lesions, 14 centers (21%) delayed DVT prophylaxis until 72 hours after trauma. If hemorrhagic brain lesions were present, the number of centers delaying DVT prophylaxis for 72 hours increased to 29 (46%). Overall, a lack of consensus exists between European ICUs on [[blood transfusion]] and coagulation management. The results provide a baseline for the CENTER-TBI study and the large between-center variation indicates multiple opportunities for comparative effectiveness research
((Huijben JA, van der Jagt M, Cnossen MC, Kruip MJHA, Haitsma I, Stocchetti N,
Maas A, Menon D, Ercole A, Maegele M, Stanworth SJ, Citerio G, Polinder S,
Steyerberg EW, Lingsma H. Variation in blood transfusion and coagulation
management in Traumatic Brain Injury at the Intensive Care Unit: A survey in 66
neurotrauma centers participating in the Collaborative European NeuroTrauma
Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. J
Neurotrauma. 2017 Aug 21. doi: 10.1089/neu.2017.5194. [Epub ahead of print]
PubMed PMID: 28825511.
)).