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KMID : 0388720210280030080
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Journal of Korean Society of Spine Surgery
2021 Volume.28 No. 3 p.80 ~ p.85
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Factors Related to the Time Interval from Injury to Emergent Surgical Management In Cases of Traumatic Cervical Spinal Injury
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Choi Byung-Wan
Kim Sung-Soo
Kim Ho-Jin
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Abstract
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Study Design: Retrospective case analysis.
Objectives: The aim of this study was to identify the factors that influence the time interval between trauma and emergency surgery in individuals with cervical spine trauma.
Summary of Literature Review: Patient-related and healthcare-related factors could influence surgical delays. However, there is a lack of studies on this issue in Korean patients.
Materials and Methods: In 145 cases of traumatic cervical spinal injury, we evaluated the time between trauma and arrival at the emergency room (ER), as well as the time between trauma and emergency surgery. The following factors were analyzed in terms of their relationship with the time between trauma and emergency surgery: age, sex, department, the time between trauma and arrival at the emergency room (ER), the time interval until the first medical assessment, whether the injury occurred on a weekday or weekend, the physician at the first assessment, previous visits to other hospitals, combined injuries, the cause of the injury, and whether the patient had consumed alcohol.
Results: The total average time between trauma and operation was 89.53 hours. This interval was significantly related to the time intervals until arrival at the ER (15.46 hours), until the first assessment (2.03 hours), and until emergency surgery (72.03 hours) (p<0.001).
The first-assessment physician (p=0.043) and ASIA impairment score (p<0.001) were related to an early operation. Severity of paralysis was related to the time until arrival (p=0.008), the first assessment (p=0.009), and emergency surgery (p<0.001).
Conclusions: The time between trauma and emergency surgery in patients with a cervical spine injury was related to the time between the first assessment and surgery. Early surgery tended to be performed when paralysis was severe, surgery was performed by the department that conducted the first assessment, surgical planning was faster, and there was access to the operating room.
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KEYWORD
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Cervical trauma, Emergency operation, ASIA scale, Time delay
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