Predictors of the short-term outcome of emergency neurosurgeries; a cross-sectional study

Abstract

Background: Emergency neurosurgery plays a critical role in the management of life-threatening neurological disorders. Previous studies have shown that the initial clinical status and prolonged time interval to surgery affect patient mortality and morbidity. This study aimed to describe the association of the baseline and clinical characteristics of patients and the timing of intervention with the emergency neurosurgical intervention outcomes. Methods: A retrospective cross-sectional study was conducted involving all patients who received emergency surgery in the theatre of Udayana University Hospital from June 2021 until 2023. Age, gender, type of surgical procedures, severity of trauma, Glasgow coma scale (GCS) at emergency room arrival, time to theatre (TTT), the duration of the operation, and length of stay (LOS) were collected. Mortality was defined as the primary outcome. Results: 43 emergency surgeries were included. The mean age was 42.35 (±21.85) years and the majority of patients were male (69.8%). 65.1% of patients were trauma cases and 51.2% underwent craniotomy. The median GCS at the time of admission was 9, the median TTT was 3 hours, the median duration of surgery was 2.41 hours, and the median LOS was 7 days. After the procedures, the survival rate was 67.4%. The GCS upon admission (p=0.003) and TTT (p=0.044) were significantly associated with the patient's mortality. Conclusion: GCS at emergency room arrival and TTT in emergency surgery were associated with the mortality of emergency neurosurgery patients.

Keywords

• Emergency
• Neurosurgery
• Surgery
• Time
• survival