Door-to-Skin Time in Patient Undergoing Emergency Trauma Craniotomy
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Door-to-Skin Time in Patient Undergoing Emergency Trauma Craniotomy
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Kumarappan Chockalingam, Noor Azman A Rahman, Zamzuri Idris, Sharon Casilda Theophilus, Jafri Malin Abdullah, Abdul Rahman Izaini Ghani, Aisyah Ali
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Door-to-Skin Time in Patient Undergoing Emergency Trauma Craniotomy
Year: 2023 | Doi: 10.21315/mjms2023.30.4.7
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Traumatic brain injury (TBI) remains a significant global healthcare challenge, ranking as the third leading cause of death and disability as of 2020, especially within developing nations like Malaysia. This study focuses on evaluating the time taken from patient admission to definitive surgical intervention for TBI at a neurosurgery referral center, Hospital Sultanah Aminah Johor Bahru. It aims to analyze the impact of delays in surgical operations on patient outcomes, particularly considering the role of factors such as polytrauma, hypotensive episodes, and the door-to-skin time.
The Importance of Timely Surgical Intervention
One key finding of the study is the critical relationship between door-to-skin time and patient outcomes in TBI cases. The research demonstrated that for every minute of delay in surgical intervention, the chances of poor patient outcomes increased. At discharge, 68.2% of the patients had poor outcomes, which reduced to 37.7% at the six-month follow-up, further emphasizing that timely surgery is crucial in improving survival and recovery rates. Simple logistic regression analyses indicated that severe TBI, the presence of multiple injuries, and episodes of hypotension were also significantly related to negative outcomes, reinforcing the necessity for immediate medical attention and surgery in critical cases.
Conclusion
In conclusion, the study highlights the urgent need for improvements in trauma care protocols to minimize delays in surgical interventions faced by TBI patients at the regional neurosurgery center in Malaysia. An effective response to reducing door-to-skin time is essential for enhancing patient outcomes, emphasizing the collaboration among all parties involved in trauma care. Therefore, a concerted effort to streamline processes, enhance communication, and prioritize neurotrauma care can lead to better survival rates and recovery for patients with traumatic brain injuries in Malaysia.
FAQ section (important questions/answers):
What is the leading cause of death related to TBI?
Traumatic brain injury (TBI) was the third leading cause of death globally in 2020, significantly contributing to morbidity and mortality rates.
What is door-to-skin time in emergency treatment?
Door-to-skin time refers to the interval from a patient's arrival at the hospital to the time when surgical intervention begins. This study highlights its direct impact on patient outcomes.
What factors influence poor outcomes in TBI patients?
Poor outcomes in TBI patients are associated with factors such as polytrauma, hypotensive episodes, mechanical ventilation, severe TBI, and extended door-to-skin times.
How did the study evaluate TBI surgical interventions?
This retrospective study assessed emergency craniotomy timing for TBI patients, analyzing various time intervals, clinical characteristics, and their correlation with patient outcomes over six months.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Door-to-Skin Time in Patient Undergoing Emergency Trauma Craniotomy”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
Table refers to a structured arrangement of data, often displayed in rows and columns, making it easier to analyze and interpret complex information. In the context of the study, tables are vital for summarizing demographic and clinical characteristics of patients, treatment timelines, and outcomes, facilitating comparisons and discussions within research findings.
2) Study (Studying):
A study is a systematic investigation aimed at discovering or confirming facts, theories, or principles related to a particular subject. In medical research, studies like the one presented are essential for assessing patient outcomes, evaluating interventions, and providing evidence-based recommendations to improve clinical practices and informed decision-making in the treatment of conditions such as traumatic brain injury.
3) Pur:
Poor refers to inadequate performance or lower-than-acceptable results, particularly concerning health outcomes. In the context of traumatic brain injury (TBI), patients may experience poor outcomes reflecting diminished recovery, increased disability, or mortality rates defined by clinical assessments like the Glasgow Outcome Score, underscoring the need for timely medical intervention to improve patient prognosis.
4) Death:
Death is the cessation of life and is a critical outcome to track in medical studies. Understanding mortality rates associated with traumatic brain injury helps researchers and clinicians evaluate the severity of injuries and the effectiveness of treatment protocols, guiding improvements in care and educational efforts aimed at reducing preventable fatalities.
5) Reason:
Reason refers to a rationale or explanation for something that has occurred. In clinical research, identifying reasons for delays or adverse outcomes—such as poor patient responses or prolonged surgical intervention—is crucial for developing strategies to enhance trauma care efficiency and effectiveness, ultimately improving patient outcomes in difficult medical scenarios.
6) Rules:
Rules are established guidelines or protocols that dictate how procedures should unfold in various settings. In medicine, clinical guidelines are critical for directing diagnoses, treatments, and interventions. Understanding and adhering to these rules ensures that patients receive evidence-based care and minimizes the risk of complications or errors during treatment.
7) Life:
Life signifies the existence of biological organisms and is a central focus of healthcare. In a medical context, maintaining and improving life is the primary goal of interventions and treatments. Examining factors that affect survival, such as timely surgical evaluation in TBI cases, is essential for enhancing life expectancy and quality of health.
8) Performance:
Performance refers to the effectiveness and outcomes of medical interventions as measured against expected standards. In the study, evaluating performance metrics, such as door-to-skin times and patient recovery, provides insights into the effectiveness of trauma care systems and helps identify areas for improvement in clinical practices and resource allocation.
9) Incision:
Incision refers to a surgical cut made in the skin or tissue to perform a medical procedure, particularly in surgical settings. The timing from patient arrival to incision—including factors affecting this duration—can significantly impact patient outcomes, especially in emergency surgeries for traumatic brain injuries where timely intervention is critical.
10) Road:
Road often symbolizes the pathways taken in transport or transfer of patients to medical facilities. In trauma care, understanding road conditions and transportation times can help identify logistical challenges affecting timely access to emergency services, impacting patient outcomes especially in cases of severe injuries requiring prompt surgical intervention.
11) Arrangement:
Arrangement refers to the organization or scheduling of resources, tasks, or personnel. In medical contexts, proper arrangement is crucial for ensuring timely surgeries and effective treatments. Efficiently arranged healthcare logistics can reduce delays that adversely affect patient outcomes, particularly in urgent cases, as seen in the management of traumatic brain injuries.
12) Relative:
Relative represents a family member or person connected by blood or marriage. In medical scenarios, relatives often play a significant role in decision-making regarding patient care, especially in cases requiring consent for treatment. Open communication with relatives can facilitate timely interventions and better understanding of patient healthcare needs during emergencies.
13) Line:
Line can denote a route, a type of division, or a boundary in various contexts. In medical terms, it may refer to anatomical lines such as surgical incision lines, which are critical for healthcare providers to understand during procedures. Clear delineation assists proper technique and aesthetic outcomes in surgical practices to aid recovery.
14) Mud:
Mood refers to emotional states and can have significant implications for patient recovery post-therapy. In studies involving brain injuries, understanding the psychological and emotional aspects of recovery, such as mood changes, can help in developing comprehensive care plans that address both physical and mental health needs for better holistic outcomes.
15) Developing:
Developing pertains to the growth or progression of countries or regions, often in terms of healthcare infrastructure. In the context of trauma care, developing regions may face unique challenges, such as limited resources and access to specialized services, emphasizing the need for targeted strategies and investments to improve outcomes for traumatic brain injuries.
16) Attending:
Attending refers to medical professionals providing care or supervision in healthcare settings. The role of attending clinicians is crucial in coordinating patient assessment and management, ensuring that trauma patients receive timely, appropriate care. Their decisions significantly affect patient outcomes, especially during critical moments following traumatic injuries.
17) Medicine:
Medicine encompasses the science and practice of diagnosing, treating, and preventing illnesses and injuries. Continued advancements in medicine are essential for improving trauma care protocols and patient outcomes. Research studies contribute to building a robust evidence base that drives innovations and improves the standards of care provided to patients.
18) Bleeding:
Bleeding, or hemorrhage, refers to the loss of blood resulting from vascular injury or trauma. In the context of traumatic brain injury, understanding the mechanisms of bleeding and its management is crucial for effective intervention strategies to prevent secondary brain injuries and improve recovery prospects for affected patients requiring surgical procedures.
19) Krishna (Krsna):
Krishna appeared as a reference within the context of the referenced studies regarding traumatic brain injury and surgical methods. Referring to authoritative figures in linked research assists in understanding the body of knowledge surrounding TBI management, contributing to a clearer comprehension of evolving treatment methodologies and patient outcomes.
20) Kampala:
Kampala, the capital city of Uganda, may serve as a reference point in global studies on trauma care and resource allocation in clinical settings. Research from different geographical locations, like Kampala, aids in comparing the effectiveness of emergency medical systems and outcomes, especially in settings similar to Malaysia’s healthcare context.
21) Bullock:
Bullock represents a key author in trauma surgery studies, particularly guidelines for managing traumatic brain injuries. Referencing Bullock's work emphasizes the importance of established standards in surgical protocols, which can drive improvements in patient outcomes and address delays in care often encountered in trauma settings.
22) Thomas:
Thomas could refer to one of the studies or authors relevant within the context of traumatic brain injury research, contributing to the body of knowledge regarding trauma management practices. Acknowledging various expert contributions enriches understanding of complex medical issues and underscores collaborative efforts necessary for effective treatment approaches.
23) Family:
Family denotes the patient’s relatives who often influence healthcare decisions, especially in emergencies. Engaging families during treatment discussions can promote better care outcomes, as they provide essential context about the patient's history and preferences. Furthermore, involving families in care plans can lead to increased patient satisfaction and cooperation.
24) Gupta:
Gupta is likely a reference to an author or key figure in research pertaining to medical studies on traumatic brain injuries. Including Gupta's findings helps bolster the credibility of the research landscape on TBI, encouraging a dialogue around enhancing trauma response systems and improving clinical outcomes for affected patients.
25) Karmin (Karmi):
Karmi refers to an author associated with research on urgent neurosurgical interventions and outcomes. Acknowledging Karmi's contributions helps highlight the ongoing discourse around urgent medical procedures and their implications for patient care. Integrating such insights is vital for shaping trauma management protocols to optimize patient recovery.
26) Vaca:
Vaca could reference a researcher involved in trauma care studies, emphasizing the generation of knowledge surrounding the timing of surgical interventions in TBI patients. Recognizing Vaca's work contributes to understanding the complexities surrounding timely trauma care and the associated patient outcomes, influencing future clinical guidelines.
27) Post:
Post refers to the period after an event, often associated with aftercare or follow-up. In trauma medicine, understanding post-operative outcomes and patient recovery is critical for assessing the efficacy of surgical procedures. Post-intervention studies are fundamental for gaining insights into long-term patient impacts and areas for improvement in care.
28) Discussion:
Discussion in research refers to the analysis and interpretation of findings. It offers a platform for summarizing results, exploring implications, and proposing future research directions. In medical studies, the discussion is crucial for contextualizing results within existing literature, enhancing understanding of clinical practices and how they affect patient care.
29) Accumulation (Accumulating, Accumulate):
Accumulate refers to the process of gathering or amassing something over time. In a medical context, knowledge and clinical experiences accumulate through ongoing research and patient interactions. This accumulation is vital for advancing treatment protocols and improving health outcomes, particularly in complex fields like trauma surgery and emergency medicine.
30) Knowledge:
Knowledge pertains to the understanding and information acquired through education or experience. In healthcare, accumulating knowledge from research is essential for practitioners to provide effective, evidence-based care to patients. Knowledge drives advancements in treatment methodologies and informs best practices for handling acute conditions such as traumatic brain injury.
31) Education:
Education represents the systematic instruction and training of individuals. In medical contexts, continuous education for healthcare professionals is essential to keep up with evolving knowledge, practices, and technologies. Enhancing education fosters improvement in trauma care, ultimately leading to better patient outcomes and more effective healthcare systems.
32) Account:
Account can refer to a record or report of an event or transaction. In medical practices, maintaining accurate accounts of patient histories, treatments, and outcomes is crucial for informed clinical decisions. Reliable accounts contribute significantly to ongoing patient management and serve as a basis for future medical research and improvements.
33) Science (Scientific):
Science signifies the systematic pursuit of knowledge through observation, experimentation, and analysis. In medicine, scientific principles underpin research and clinical practices, guiding interventions. The application of scientific methodology ensures that trauma treatments and protocols are based on robust evidence, improving the quality of patient care and health outcomes overall.
34) Edema (Oedema):
Oedema refers to tissue swelling caused by excess fluid accumulation, commonly observed in brain injuries. Managing oedema is crucial for preventing further complications post-trauma. Understanding its implications, particularly in TBI, helps healthcare providers make informed treatment decisions towards effective stabilization and recovery strategies for affected individuals.
35) Nature:
Nature signifies the inherent qualities or characteristics of a phenomenon or individual. In medical research, understanding the nature of a condition, such as traumatic brain injury, provides insight into its underlying mechanisms, essential for developing targeted interventions and improving patient outcomes in acute care settings.
36) Indian:
Indian may refer to the nationality of individuals or to studies conducted in India, notably highlighting the demographic diversity in healthcare research. Understanding varying cultural contexts contributes to developing tailored approaches in trauma care, ensuring inclusivity in medical practices, and addressing healthcare disparities witnessed in diverse populations.
37) Filling (Filled):
Filled describes a state of being made full or occupied. In trauma care, filled could metaphorically refer to addressing gaps in care or resources. Ensuring that healthcare systems are filled with essential resources, trained personnel, and effective protocols is imperative for providing timely and adequate responses to traumatic injuries.
38) Kulai:
Kulai is a district in Johor, Malaysia, which could highlight the geographical context of the study. Recognizing regional influences on healthcare—such as infrastructure, access to services, and patient demographics—is critical for understanding the challenges faced by trauma centers and informs improvements in local healthcare systems.
39) Kota:
Kota represents another location potentially tied to the study or healthcare services in Malaysia. Understanding different regions' healthcare capacities is vital for addressing regional disparities in trauma care, which can directly affect the timeliness and effectiveness of treatment received by patients with traumatic injuries.
40) King:
King may refer to an individual relevant to the context of research, such as an author or researcher contributing to trauma studies. Recognizing key figures in medical literature helps contextualize findings, enrich understanding of treatment approaches, and encourage collaboration in investigation and management of traumatic injuries.
41) Coma:
Coma refers to a state of profound unconsciousness resulting from severe brain injury. Assessment of patients in comatose states is crucial in healthcare, as it assists in determining prognosis and potential recovery outcomes. Understanding the dynamics of coma can guide treatment strategies and decision-making processes in critical care scenarios.
42) Male:
Male identifies the gender of individuals involved in the study. Evaluating gender differences in trauma outcomes is critical for understanding how biological and social factors may influence responses to treatment. This insight can help in creating more targeted and effective interventions suitable for patients' specific gender-related needs.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Door-to-Skin Time in Patient Undergoing Emergency Trauma Craniotomy’. Further sources in the context of Science might help you critically compare this page with similair documents:
Medical practitioner, Surgical intervention, Patient care, Surgery, Informed consent, Conflict of interest, Statistical analysis, Follow-up, Time interval, Patient, Medical research, Inclusion criteria, Exclusion criteria, Ethical committee, CT scan, Mortality Rate, Emergency Surgery, Functional recovery, Interquartile Range, Intervention, Medical emergency, Emergency medicine, Glasgow Coma Scale, Clinical trial registration, Early management, Head injury, Surgical outcome, Multidisciplinary team, Emergency laparotomy, Logistic regression, Elective surgery, Traumatic brain injury, Road traffic accident, Adjusted odds ratio, In-hospital mortality, Intracranial Pressure, Logistic regression analysis, Early surgical intervention, Surgical evacuation, Logistic Support, Surgical Team, Poor outcome, Polytrauma, Mass effect, Definitive care, Secondary brain injury, Primary brain injury, Brain injury, Clinical factors, Crude odds ratio, Motor vehicle accident, Neurosurgical intervention, Ministry of Health Malaysia, Clinical deterioration, Extradural haemorrhage, Subdural haemorrhage, Authors contribution, Study material, Population size, Medical record.
Concepts being referred in other categories, contexts and sources.