The Effectiveness of Dedicated Trauma Operation Theatre and Trauma Intensive Care Unit on the Outcomes of Patients with Traumatic Brain Injury after Emergency Neurosurgery.

Abstract

Background: A dedicated trauma operation theatre (TOT) and a trauma intensive care unit (TICU) within the same block as the emergency department (ED) can facilitate immediate management and surgery of patients suffering from traumatic brain injury (TBI). The present study compared the effectiveness and outcomes of TBI management between the TOT-TICU and general OT (GOT) and neuro-ICU (NICU) setups.

Methods: This was a retrospective cohort study involving 120 patients with TBI who were divided into the GOT-NICU (n = 63) and TOT-TICU (n = 57) groups. Data were obtained from patients' admission and medical records. Demographic data, durations of specific management phases and outcomes of patients were documented.

Results: In the TOT-TICU group, the duration of transportation from ED to OT [15 (standard deviation [SD] = 15) min versus 45 (SD = 15) min; P < 0.001], duration of arrival in OT to incision [50 (SD = 30) versus 70 (SD = 23) min; P = 0.005] and duration of transportation from OT to ICU [40 (SD = 17) versus 48 (SD = 30); P = 0.005] were significantly shorter than those in the GOT-NICU group. However, the duration of mechanical ventilation, duration of ICU stays, Glasgow Outcome Scale (GOS) upon discharge and GOS at 3-month post-discharge were comparable between both groups.

Conclusion: The TOT-TICU setup shortened the duration of transportation from ED to OT, duration of arrival in OT to incision and duration of transportation from OT to ICU compared with the GOT-NICU setup. Hence, the availability of OT and ICU within the trauma block managed to provide immediate management to TBI patients.