General surgeon performed emergency craniotomies in regional Queensland hospitals: a 20‐year state‐wide study on patient outcomes

• DOI: 10.1111/ans.18911
• Publication Date: 2024-03-30T08:39:12Z
• Authors: Madeleine Louise ...; Michael Stuart; Jason Zouki; Brittany Long; Nestor Sabat; Claudia Rose Clark; Eric Donaldson; Rachel Emily Colbran
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Abstract Background Traumatic brain injuries account for up to 50% of trauma related deaths and if surgical intervention is indicated, consensus suggests a maximum 4 hours decompression. The occurrence outcomes craniotomies performed by non‐neurosurgeons in regional Queensland hospitals have never been reported previously the literature. Methods A retrospective review was at all without an on‐site neurosurgical service from January 2001 December 2022 identify patients undergoing emergency craniotomy. Data recorded included basic demographics, history anti‐coagulant use, mechanism injury, type haemorrhage, Glasgow Coma Score Outcome Scale (GOS) on discharge. Radiological parameters measured midline shift maximal coronal depth haematoma. primary aim this study assess clinical radiological who underwent craniotomy general surgeons. Results Over past 20 years there 23 decompressive procedures (one excluded) Queensland. Preoperative imaging demonstrated 9 extradural haematomas 13 subdural haematomas. Six 17 transferred cases required reoperation after transfer centre. Survival observed 22 cases, with ‘good’ functional outcome (GOS ≥3) 7 cases. In no were rurally burr holes effective. Discussion Qualitatively, larger may be associated better outcomes. Although rare occurrences, our results demonstrate that surgeon are frequently efficacious producing and/or improvement should considered as potentially lifesaving procedure.