Khan Zahid, Sharafat Seema, Ali Haidar, Khan Adnan, Noushad Ahmad, Farman Javaria, Sajjad Muhammad
Neurosurgery, Lady Reading Hospital Medical Teaching Institution, Peshawar, PAK.
Emergency and Trauma Unit, Lady Reading Hospital Medical Teaching Institution, Peshawar, PAK.
Cureus. 2025 Feb 18;17(2):e79250. doi: 10.7759/cureus.79250. eCollection 2025 Feb.
Extradural hematoma (EDH) is a life-threatening neurosurgical emergency, with timely surgical intervention critical to preventing neurological deterioration and improving patient outcomes. Delays in surgical treatment are a persistent concern, yet the specific impact of pre-surgical delays on clinical outcomes in EDH patients remains underexplored.
This study aimed to evaluate the impact of pre-surgical delay duration on clinical outcomes in patients with EDH, specifically examining survival rates, neurological status, and recovery outcomes.
A retrospective observational study was conducted over a two-year period (January 2022 to December 2023). Patients aged 18 years and above, diagnosed with EDH and undergoing surgical intervention, were included. Data on pre-surgical delays, demographics, comorbidities, and clinical outcomes were collected from medical records. Statistical analyses included t-tests and multivariate regression to identify predictors of adverse outcomes.
A total of 178 patients were analyzed. The mean pre-surgical delay was significantly longer in deceased patients (16.42 ± 6.24 hours) compared to survivors (7.92 ± 3.81 hours) (p < 0.001). Shorter pre-surgical delays (6.31 ± 2.52 hours) were associated with higher rates of full recovery compared to longer delays (12.18 ± 4.29 hours) (p < 0.001). Multivariate analysis identified pre-surgical delay, age, hypertension, and diabetes as significant predictors of adverse outcomes.
Pre-surgical delays significantly impact survival rates and recovery outcomes. Addressing logistical issues, resource constraints, and comorbid conditions is essential to minimize delays and improve patient prognosis.
硬膜外血肿（EDH）是一种危及生命的神经外科急症，及时进行手术干预对于预防神经功能恶化和改善患者预后至关重要。手术治疗的延迟一直是一个令人担忧的问题，但术前延迟对EDH患者临床结局的具体影响仍未得到充分研究。
本研究旨在评估术前延迟时间对EDH患者临床结局的影响，具体考察生存率、神经状态和恢复情况。
进行了一项为期两年（2022年1月至2023年12月）的回顾性观察研究。纳入年龄在18岁及以上、诊断为EDH并接受手术干预的患者。从病历中收集术前延迟、人口统计学、合并症和临床结局的数据。统计分析包括t检验和多变量回归，以确定不良结局的预测因素。
共分析了178例患者。与幸存者（7.92±3.81小时）相比，死亡患者的平均术前延迟时间明显更长（16.42±6.24小时）（p<0.001）。与较长延迟（12.18±4.29小时）相比，较短的术前延迟（6.31±2.52小时）与更高的完全恢复率相关（p<0.001）。多变量分析确定术前延迟、年龄、高血压和糖尿病是不良结局的重要预测因素。
术前延迟显著影响生存率和恢复结局。解决后勤问题、资源限制和合并症对于尽量减少延迟和改善患者预后至关重要。
