SURGICAL DELAY IN PATIENTS WITH SUBAXIAL FRACTURE.

Abstract

Objective: This retrospective study investigated the waiting time for surgery in patients with severe subaxial cervical fractures at Santa Casa de Misericórdia de São Paulo, as well as identifying the main causes of surgical delays.

Methods: The research was quantitative and retrospective, utilizing medical records of patients operated on between January 2015 and June 2023. Variables analyzed included age, gender, trauma mechanism, fracture classification, neurological status, waiting time until surgery, and causes of delay. Data were initially collected using physical forms and then migrated to electronic platforms (SurveyMonkey^® and Red Cap^®) for detailed statistical analysis.

Results: The study included 36 patients, with a significant predominance of men (86.1%) and an average age of 44.97 years. Falls were the most common trauma mechanism (44.4%), followed by automobile accidents (27.8%). Most fractures occurred at the C4/C5 (16.7%) and C5/C6 (13.9%) levels. The most frequent AO type classification was type C (47.2%). The average waiting time for surgery was 9.28 days, with the main cause of delay being the availability of the operating room (66.7%).

Conclusion: The results indicate that cervical fractures have a significant impact on young adults, predominantly men, often associated with falls and automobile accidents. Early identification and timely surgical intervention are crucial to minimize complications and improve neurological outcomes. Strategies to reduce surgical waiting times, such as improvements in hospital resource management, are essential to optimize the treatment of these injuries. Level of Evidence III; Retrospective Cohort Study.