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Door-to-Skin Time in Patient Undergoing Emergency Trauma Craniotomy
Kumarappan Chockalingam1,2,3, Noor Azman A Rahman1, Zamzuri Idris2,3
1Department of Neurosurgery, Hospital Sultanah Aminah Johor Bahru, Johor, Malaysia.
The Malaysian Journal of Medical Sciences : MJMS
|September 1, 2023
Summary
Delays in surgical intervention for traumatic brain injury (TBI) patients with intracranial bleeds are directly linked to poorer outcomes. Reducing door-to-skin time is crucial for improving patient survival and recovery in TBI care.
Area of Science:
- Neurosurgery
- Trauma Care
- Public Health
Background:
- Traumatic brain injury (TBI) is a significant global cause of death and disability.
- Urgent surgical intervention is critical for TBI patients with intracranial bleeds.
Purpose of the Study:
- To evaluate the time to definitive surgical intervention after admission.
- To assess the association between this surgical delay and patient outcomes in a Malaysian neurosurgery center.
Main Methods:
- Retrospective study of 154 TBI patients requiring urgent craniotomy.
- Data extracted from clinical records, including Glasgow Outcome Score (GOS) at discharge and 6 months.
- Logistic regression analysis to identify factors associated with poor outcomes.
Main Results:
- Median door-to-skin time was 605 minutes.
- 68.2% of patients had poor outcomes at discharge, improving to 37.7% at 6 months.
- Increased door-to-skin time was significantly associated with poor outcomes at both discharge (AOR=1.005) and 6 months (AOR=1.008).
Conclusions:
- Door-to-skin time is directly proportional to poor outcomes in TBI patients.
- Minimizing delays in surgical intervention is essential for improving patient outcomes.
- Collaborative efforts in trauma care are needed to streamline surgical interventions.
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