Assessing the Impact of Pre-surgical Delay on Extradural Hematoma Outcomes.

BACKGROUND

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.

OBJECTIVE

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.

METHODOLOGY: 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.

RESULTS

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.

CONCLUSION

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.