Evidence map›Paper›PMID 27034712›Full record

ArticleWorld journal of emergency surgery : WJES2016

Risk factors for delayed neuro-surgical intervention in patients with acute mild traumatic brain injury and intracranial hemorrhage.

Fu-Yuan Shih, Hsin-Huan Chang, Hung-Chen Wang, Tsung-Han Lee, Yu-Jun Lin, Wei-Che Lin, Wu-Fu Chen, Jih-Tsun Ho, Cheng-Hsien Lu

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of emergency surgery : WJES, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Fu-Yuan Shih *Departments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Hsin-Huan Chang *Departments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Hung-Chen WangDepartments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Tsung-Han LeeDepartments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Yu-Jun LinDepartments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Wei-Che LinDepartments of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Wu-Fu ChenDepartments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Jih-Tsun HoDepartments of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Cheng-Hsien LuDepartments of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMild traumatic brain injury (TBI) patients with initial traumatic intracranial hemorrhage (tICH) and without immediate neuro-surgical intervention require close monitoring of their neurologic status. Progressive hemorrhage and neurologic deterioration may need delayed neuro-surgical intervention. This study aimed to determine the potential risk factors of delayed neuro-surgical intervention in mild TBI patients with tICH on admission.

methodsThree hundred and forty patients with mild TBI and tICH who did not need immediate neuro-surgical intervention on admission were evaluated retrospectively. Their demographic information, clinical evaluation, laboratory data, and brain CT was reviewed. Delayed neuro-surgical intervention was defined as failure of non-operative management after initial evaluation. Risk factors of delayed neuro-surgical intervention on admission were analyzed.

resultsDelayed neuro-surgical intervention in mild TBI with tICH on initial brain CT accounted for 3.8 % (13/340) of all episodes. Higher WBC concentration, higher initial ISS, epidural hemorrhage (EDH), higher volume of EDH, midline shift, and skull fracture were risk factors of delayed neuro-surgical intervention. The volume of EDH and skull fracture is independent risk factors. One cubic centimeter (cm3) increase in EDH on initial brain CT increased the risk of delayed neurosurgical intervention by 16 % (p = 0.011; OR: 1.190, 95 % CI:1.041-1.362).

conclusionsMild TBI patients with larger volume of EDH have higher risk of delayed neuro-surgical interventions after neurosurgeon assessment. Longer and closer neurological function monitor and repeated brain image is required for those patients had initial larger EDH. A large-scale, multi-centric trial with a bigger study population should be performed to validate the findings.

Indexed as

Mild traumatic brain injuryRisk factorSurgical intervention

Identifiers

PMID27034712
PMCPMC4815160

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.