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

Overview of attention for article published in World Journal of Emergency Surgery, March 2016
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Title
Risk factors for delayed neuro-surgical intervention in patients with acute mild traumatic brain injury and intracranial hemorrhage
Published in
World Journal of Emergency Surgery, March 2016
DOI 10.1186/s13017-016-0069-2
Pubmed ID
Authors

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

Mild 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. Three 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. Delayed 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). Mild 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.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Mexico 1 3%
Unknown 29 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 23%
Student > Bachelor 5 17%
Other 3 10%
Student > Doctoral Student 3 10%
Student > Ph. D. Student 2 7%
Other 3 10%
Unknown 7 23%
Readers by discipline Count As %
Medicine and Dentistry 10 33%
Nursing and Health Professions 4 13%
Psychology 3 10%
Biochemistry, Genetics and Molecular Biology 2 7%
Neuroscience 2 7%
Other 2 7%
Unknown 7 23%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 April 2016.
All research outputs
#20,317,110
of 22,858,915 outputs
Outputs from World Journal of Emergency Surgery
#473
of 547 outputs
Outputs of similar age
#255,093
of 301,001 outputs
Outputs of similar age from World Journal of Emergency Surgery
#7
of 9 outputs
Altmetric has tracked 22,858,915 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 547 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 301,001 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.