Emergent operation for isolated severe traumatic brain injury: Does time matter?

The Journal of Trauma and Acute Care Surgery
Kazuhide MatsushimaDemetrios Demetriades

Abstract

It remains unclear whether the timing of neurosurgical intervention impacts the outcome of patients with isolated severe traumatic brain injury (TBI). We hypothesized that a shorter time between emergency department (ED) admission to neurosurgical intervention would be associated with a significantly higher rate of patient survival. Our institutional trauma registry was queried for patients (2003-2013) who required an emergent neurosurgical intervention (craniotomy, craniectomy) for TBI within 300 minutes after the ED admission. We included patients with altered mental status upon presentation in the ED (Glasgow Coma Scale [GCS] score < 9). Patients with associated severe injuries (Abbreviated Injury Scale [AIS] score ≥ 2) in other body regions were excluded. In-hospital mortality of patients who underwent surgery in less than 200 minutes (early group) was compared with those who underwent surgery in 200 minutes or longer (late group) using univariate and multivariate analyses. A total of 161 patients were identified during the study time frame. Head computed tomographic scan demonstrated subdural hematoma in 85.8%, subarachnoid hemorrhage in 55.5%, and equal numbers of epidural hematoma and intraparenchymal hemorrhage in 22.6%...Continue Reading

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Citations

Jan 26, 2018·The Journal of Trauma and Acute Care Surgery·Kazuhide MatsushimaDemetrios Demetriades
Sep 21, 2018·Journal of Neurotrauma·Thomas A van EssenGodard C W de Ruiter
Nov 6, 2018·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Marike Zwienenberg, James P Marcin
Aug 23, 2018·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Eric M JacksonCorina Noje
Jan 20, 2019·Journal of Neurosurgery·Saksham GuptaKee B Park
Aug 11, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Bartłomiej KuleszaRadosław Rola
Aug 5, 2016·The Journal of Trauma and Acute Care Surgery·Jonathan P MeizosoNicholas Namias
Dec 14, 2018·Neurosurgical Focus·Stacy A ShackelfordDonald W Marion
Oct 8, 2019·The Journal of Trauma and Acute Care Surgery·Aaron R JensenJeffrey S Upperman
Nov 28, 2019·Journal of Neurotrauma·Min Kyoung SunLohitash Karumbaiah
Mar 17, 2016·Journal of Critical Care·Jerry A RubanoRandeep S Jawa
Feb 28, 2021·Journal of Neurotrauma·Dylan P GriswoldAndres M Rubiano

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.