Time from injury to acute surgery for patients with traumatic cervical spinal cord injury in South-East Norway

Frontiers in Neurology, 2024 · DOI: 10.3389/fneur.2024.1420530 · Published: June 24, 2024

Simple Explanation

This study investigates the timing of surgical intervention for cervical spinal cord injuries (cSCI) within a specific health region of Norway. The goal was to see how well the institution complied with the recommendation of performing surgery within 24 hours of the injury. The research also sought to identify factors that might delay surgical intervention. By analyzing patient data, the researchers aimed to pinpoint areas in the healthcare system that could be improved to ensure quicker treatment for cSCI patients. The ultimate goal is to enhance patient outcomes by optimizing the time between injury and surgery, aligning with established guidelines for cSCI management.

Study Duration

2015-2022 (8 years)

Participants

243 cSCI patients having acute neck surgery

Evidence Level

Retrospective database study

Key Findings

1
Less than half (47%) of the patients with cSCI were operated on within the recommended 24 h time frame after injury.
2
A significant delay was observed at the NTC, with a median duration of 16.7 h from patient admission to the start of surgery.
3
Factors such as transfer via local hospital, severe preinjury comorbidities, and less severe cSCI were associated with increased time from injury to NTC admission.

Research Summary

This study evaluated the time from injury to surgery for patients with traumatic cervical spinal cord injury (cSCI) in South-East Norway, finding that only 47% of patients underwent surgery within the recommended 24 hours. The analysis revealed that delays primarily occurred between admission to the neurotrauma center (NTC) and the start of surgery, with factors like transfer via local hospitals and pre-existing health conditions contributing to longer wait times. The authors suggest improvements such as direct transport to the NTC, performing MRI at the NTC, and scheduling surgery promptly after arrival to enhance adherence to the 24-hour target.

Practical Implications

Direct Transport to NTC

Patients with suspected cSCI should be transported directly to the NTC to avoid delays associated with local hospital triage.

Streamlined MRI Process

MRI should be performed at the NTC to avoid diagnostic delays at local hospitals and optimize image quality.

Prompt Surgical Scheduling

Surgery should be scheduled for the same calendar day as arrival or as the first operation the following day to reduce in-house delays.

Study Limitations

1
Retrospective data collection of patient and radiology data.
2
27% of the patients with cSCI did not have surgery.
3
The degree of ongoing medullary compression on NTC admission was not assessed.

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