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Prompt emergency care and rapid surgery reduces death and disability following traumatic brain injury

For patients with traumatic brain injury (TBI), shorter time from emergency department (ED) arrival to surgery significantly lowers mortality and length of hospital stay, according to a study published in the July issue of the Journal of Emergency Nursing.

The study investigated how time from ED arrival to surgery in patients with TBI influenced hospital mortality and length of stay.  The data were collected from 493 patients from 17 level I and II trauma centers. Patient characteristics such as age, Glasgow Coma Scale score, Injury Severity score, and ED arrival time were examined, as were trauma-center characteristics, including ownership, designation type, and center level.

The investigators found that the likelihood of mortality was halved for patients who underwent craniotomy or drainage of hematoma within four hours of ED arrival compared to those who had surgery more than four hours following ED arrival (odds ratio, 0.49). A significantly shorter stay was found in patients who underwent surgery within four hours after ED arrival compared to those who had surgery more than four hours after ED arrival.

"If surgery is performed within four hours after a patient with a TBI arrives at the ED, the hospital mortality rate significantly decreases. In addition, when brain-injured patients undergo surgery within four hours of ED arrival, their LOS is significantly shorter," the author writes.

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