Pre-hospital and Intra-hospital Temporal Delays in Patients Requiring Emergent Trauma Craniotomy

Pre-hospital and Intra-hospital Temporal Delays in Patients Requiring Emergent Trauma Craniotomy. A 6-year Retrospective Analysis in a Level 1 Trauma Center

The investigators aim to retrospectively map the delays in the acute care of traumatic brain injury patients necessitating emergent craniotomies.

Study Overview

• Status: Terminated
• Conditions: Brain Injuries, Traumatic
• Intervention / Treatment: Procedure: Emergent craniotomy for traumatic brain injury

Detailed Description

Despite the high incidence of traumatic brain injury (TBI) and the high numbers of emergent craniotomies for TBI performed worldwide, publications reporting on temporal delays in these patients are very scarce. To the best of the investigators' knowledge, there are only 3 publications providing data on the intra-hospital delay and no publications on pre-hospital delay specifically for TBI patients undergoing emergent craniotomies.

The aim of the present study is to retrospectively map delays between the emergency call of the national emergency telephone dispatch to the hospital's medical emergency service (EC) and the surgical skin incision in emergent TBI craniotomies in the investigators' level 1 trauma center and to propose possible measures to improve performance.

• Study Type: Observational
• Enrollment (Actual): 67

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Traumatic brain injury patients undergoing an emergent craniotomy at our institution (a tertiary referral academic teaching hospital in Leuven, Belgium).

Description

Inclusion Criteria:

• every patient undergoing 1 of 3 surgical procedures ('removal of epidural hematoma'; 'removal of acute subdural hematoma'; and 'decompressive craniectomy'), performed between February 1, 2010 and January 31, 2016, as recorded in the surgical database of our institution.

Exclusion Criteria:

• who had a delayed clinical or radiological deterioration as a surgical indication;
• who did not have traumatic brain injury as the origin of the intracranial abnormalities;
• in whom not all aforementioned temporal or clinical data were readily available from the electronic patient file; and/or
• who were not admitted via our emergency department.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Temporal delay between emergency call and the surgical skin incision.	Temporal delay (in minutes) between emergency call of the national emergency telephone dispatch to the hospital's medical emergency service and the surgical skin incision during the emergent craniotomy for traumatic brain injury.	From the trauma onset until 24 hours after the trauma onset.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Temporal delay between emergency call and arrival at our emergency department.	Temporal delay (in minutes) between emergency call of the national emergency telephone dispatch to the hospital's medical emergency service and the arrival at the emergency department of our institution.	From the trauma onset until 24 hours after the trauma onset.
Temporal delay between arrival at our emergency department and acquisition of the first head CT slice.	Temporal delay (in minutes) between the arrival at the emergency department of our institution and the acquisition of the first head CT slice.	From the trauma onset until 24 hours after the trauma onset.
Temporal delay between acquisition of the first head CT slice and arrival in the operating room.	Temporal delay (in minutes) between the acquisition of the first head CT slice and arrival in the operating room for emergent trauma craniotomy.	From the trauma onset until 24 hours after the trauma onset.
Glasgow Outcome Scale	Glasgow Outcome Scale, acquired by a telephone questionnaire, at 6 months after the trauma	6 months after the trauma

Collaborators and Investigators

• Sponsor: Universitaire Ziekenhuizen KU Leuven
• Investigators: Principal Investigator: Bart Depreitere, MD, PhD, Universitaire Ziekenhuizen KU Leuven

Study record dates

Study Major Dates

• Study Start: February 1, 2010
• Primary Completion (Actual): January 1, 2016
• Study Completion (Actual): August 2, 2017

Study Registration Dates

• First Submitted: June 6, 2016
• First Submitted That Met QC Criteria: June 13, 2016
• First Posted (Estimated): June 16, 2016

Study Record Updates

• Last Update Posted (Actual): July 10, 2024
• Last Update Submitted That Met QC Criteria: July 9, 2024
• Last Verified: June 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Craniocerebral Trauma; Trauma, Nervous System; Brain Injuries; Brain Injuries, Traumatic
• Other Study ID Numbers: S59232

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO