NDLI: The effect of time to neurosurgical or neuroradiological intervention therapy on outcomes and quality of care after traumatic brain injury, a registry-based observational study

Content Provider	Springer Nature : BioMed Central
Author	Pansiritanachot, Wasin Riyapan, Sattha Shin, Sang Do Chantanakomes, Jirayu Thirawattanasoot, Netiporn Rangabpai, Wichayada Somboonkul, Bongkot Jeong, Joo Song, Kyoung Jun Chiang, Wen-Chiu Jamaluddin, Sabariah Faizah Kajino, Kentaro
Abstract	Background Evidence regarding the effect of time to neurosurgical and neuroradiological intervention on outcomes in traumatic brain injury (TBI) across Asia-Pacific region is limited. This study evaluates the quality of care and outcomes for TBI patients undergoing neurosurgical and neuroradiological procedures at different timings. Methods Adult TBI patients who received any neurosurgical or neuroradiological interventions during the year 2015–2022 in the Pan-Asian Trauma Outcome Study database were analyzed. The time to intervention, as the main exposure, was classified into three groups (Early, Intermediate, and Delayed) using Restricted Cubic Spline (RCS) analysis. The outcomes were in-hospital mortality and unfavorable neurological outcomes. W score was utilized to compare the quality of care among exposure groups. Multivariable logistic regression analysis and interaction analysis were performed to identify the association between the exposure groups and outcomes, reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results A total of 1,780 patients were included. From the RCS analysis, patients were classified into three groups according to time to intervention: Early (< 1.9 h), Intermediate (1.9–4.1 h), and Delayed (> 4.1 h). According to the time to intervention, W score was − 8.6 in the early group, -1.1 in the intermediate group, and + 0.4 in the delayed group. Patients receiving intermediate and delayed intervention showed significantly lower mortality (AOR 0.64, 95% CI 0.47–0.86 and AOR 0.66, 95%CI 0.48–0.90, respectively). Conclusion Early neurosurgical and neuroradiological interventions in TBI patients in the Asia-Pacific region were associated with lower quality of care and higher mortality. The quality of care should be focused and improved during the early hours of TBI.
Related Links	https://intjem.biomedcentral.com/counter/pdf/10.1186/s12245-024-00787-y.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	18651380
DOI	10.1186/s12245-024-00787-y
Journal	International Journal of Emergency Medicine
Issue Number	1
Volume Number	17
Language	English
Publisher	BioMed Central
Publisher Date	2024-12-20
Access Restriction	Open
Subject Keyword	Emergency Medicine Internal Medicine Cardiology Angiology Pediatrics Traumatic brain injury Intervention Mortality Disability
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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