Neurosurgical Department, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Rd, Chia-Yi City, Taiwan, 60002.
BMC Neurol. 2020 Jun 4;20(1):226. doi: 10.1186/s12883-020-01810-4.
The time from injury to surgery (TIS) is critical in the functional recovery of individuals with traumatic acute subdural hematoma (TASDH). However, only few studies have confirmed such notion.
The data of TASDH patients who were surgically treated in Chia-Yi Christian Hospital between January 2008 and December 2015 were collected. The significance of variables, including age, sex, traumatic mechanism, coma scale, midline shift on brain computed tomography (CT) scan, and TIS, in functional recovery was assessed using the student's t-test, Mann-Whitney U test, chi-square test, univariate and multivariate models, and receiver operating characteristic (ROC) curve.
A total of 37 patients achieved functional recovery (outcome scale score of 4 or 5) and 33 patients had poor recovery (outcome scale score of 1-3) after at least 1 year of follow-up. No significant difference was observed in terms of age, sex, coma scale score, traumatic mechanism, or midline shift on brain CT scan between the functional and poor recovery groups. TIS was found to be significantly shorter in the functional recovery group than in the poor recovery group (145.5 ± 27.0 vs. 181.9 ± 54.5 min, P-value = 0.002). TIS was a significant factor for functional outcomes in the univariate and multivariate regression models. The analysis of TIS with the ROC curve between these two groups showed that the threshold time for functional recovery in comatose patients and those with TASDH who were surgically treated was 2 h and 57.5 min.
TIS is an important factor l for the functional recovery of comatose TASDH patients who underwent surgery.
创伤性急性硬脑膜下血肿（TASDH）患者从受伤到手术的时间（TIS）对其功能恢复至关重要。但仅有少数研究证实了这一观点。
收集了 2008 年 1 月至 2015 年 12 月在嘉义基督教医院接受手术治疗的 TASDH 患者的数据。使用学生 t 检验、Mann-Whitney U 检验、卡方检验、单变量和多变量模型以及受试者工作特征（ROC）曲线评估年龄、性别、创伤机制、昏迷评分、脑 CT 扫描中线移位以及 TIS 等变量对功能恢复的意义。
37 例患者在至少 1 年的随访后功能恢复（结局量表评分为 4 或 5 分），33 例患者功能恢复不良（结局量表评分为 1-3 分）。在功能和不良恢复组之间，年龄、性别、昏迷评分、创伤机制或脑 CT 扫描中线移位无显著差异。功能恢复组的 TIS 明显短于不良恢复组（145.5±27.0 与 181.9±54.5 分钟，P 值=0.002）。TIS 在单变量和多变量回归模型中是功能结局的显著因素。ROC 曲线分析两组间 TIS 显示，昏迷和接受手术治疗的 TASDH 患者功能恢复的时间阈值分别为 2 小时和 57.5 分钟。
TIS 是接受手术治疗的昏迷 TASDH 患者功能恢复的重要因素。
