Association between Time to Emergent Surgery and Outcomes in Trauma Patients: A 10-Year Multicenter Study

Autor: Chi-Hsuan Tsai, Meng-Yu Wu, Da-Sen Chien, Po-Chen Lin, Jui-Yuan Chung, Chi-Yuan Liu, I-Shiang Tzeng, Yueh-Tseng Hou, Yu-Long Chen, Giou-Teng Yiang
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Medicina, Vol 60, Iss 6, p 960 (2024)
Druh dokumentu: article
ISSN: 1648-9144
1010-660X
DOI: 10.3390/medicina60060960
Popis: Background: Research on the impact of reduced time to emergent surgery in trauma patients has yielded inconsistent results. Therefore, this study investigated the relationship between waiting emergent surgery time (WEST) and outcomes in trauma patients. Methods: This retrospective, multicenter study used data from the Tzu Chi Hospital trauma database. The primary clinical outcomes were in-hospital mortality, intensive care unit (ICU) admission, and prolonged hospital length of stay (LOS) of ≥30 days. Results: A total of 15,164 patients were analyzed. The median WEST was 444 min, with an interquartile range (IQR) of 248–848 min for all patients. Patients who died in the hospital had a shorter median WEST than did those who survived (240 vs. 446 min, p < 0.001). Among the trauma patients with a WEST of p < 0.001). Multivariable logistic regression analysis revealed that WEST was not associated with an increased risk of in-hospital mortality (adjusted odds ratio [aOR] = 1.05, 95% confidence interval [CI] = 0.17–6.35 for 30 min ≤ WEST < 60 min; aOR = 1.12, 95% CI = 0.22–5.70 for 60 min ≤ WEST < 90 min; and aOR = 0.60, 95% CI = 0.13–2.74 for WEST ≥ 90 min). Conclusions: Our findings do not support the “golden hour” concept because no association was identified between the time to definitive care and in-hospital mortality, ICU admission, and prolonged hospital stay of ≥30 days.
Databáze: Directory of Open Access Journals