BACKGROUND: It remains unclear whether the timing of neurosurgical intervention impacts the outcome of @entity1 with isolated severe @entity131 ( @entity131 ). We hypothesized that a shorter time between emergency department (ED) admission to neurosurgical intervention would be associated with a significantly higher rate of @entity1 survival. METHODS: Our institutional @entity130 registry was queried for @entity1 (2003-2013) who required an emergent neurosurgical intervention (craniotomy, craniectomy) for @entity131 within 300 minutes after the ED admission. We included @entity1 with altered mental status upon presentation in the ED (Glasgow @entity772 Scale [GCS] score < 9). @entity1 with associated severe @entity130 (Abbreviated Injury Scale [AIS] score >=  2) in other body regions were excluded. In-hospital mortality of @entity1 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. RESULTS: A total of 161 @entity1 were identified during the study time frame. Head computed tomographic scan demonstrated subdural @entity1410 in 85.8%, @entity510 in 55.5%, and equal numbers of epidural @entity1410 and @entity548 in 22.6%. Median time between ED admission and neurosurgical intervention was 133 minutes. In univariate analysis, a significantly lower in-hospital mortality rate was identified in the early group (34.5% vs. 59.1%, p = 0.03). After adjusting for clinically important covariates in a logistic regression model, early neurosurgical intervention was significantly associated with a higher odds of @entity1 survival (odds ratio, 7.41; 95% confidence interval, 1.66-32.98; p = 0.009). CONCLUSION: Our data suggest that the survival rate of isolated severe @entity131 @entity1 who required an emergent neurosurgical intervention could be time dependent. These @entity1 might benefit from expedited process (computed tomographic scan, neurosurgical consultation, etc.) to shorten the time to surgical intervention. LEVEL OF EVIDENCE: Prognostic study, level IV.

Emergent operation for isolated severe XXXX : Does time matter?

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity131 :: ('MESH:D001930', 'Disease') :: ['TBI', 'traumatic brain injury'] @entity548 :: ('MESH:D006470', 'Disease') :: ['intraparenchymal hemorrhage'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['hematoma'] @entity130 :: ('MESH:D014947', 'Disease') :: ['injuries', 'trauma']
@entity131 :: (MESH:D001930,Disease) :: ['traumatic brain injury']
