title: The impact of time to surgery on outcomes in patients with traumatic brain injury: a literature review.
abstract: OBJECTIVE
  To review the relationship between the time interval to surgery and outcomes in patients with traumatic brain injury (TBI).
  
  
  METHODS
  A literature review was conducted by employing several search strategies, including electronic database searches and footnote chasing. The quality of the selected studies was assessed in terms of internal and external validity. Data regarding authors, publication year, sample size, surgical procedure, time interval to surgery, and outcome was extracted.
  
  
  RESULTS
  Among 16 finally selected studies, five studies (31.3%) found that patient outcome was significantly affected by the timing of surgery and 11 (68.7%) did not. The impact of time to surgery on outcomes was not significant in most (75%) of the studies targeting patients with severe TBI. The effect of time to surgery on outcome showed different findings depending on the type of surgical procedure. A significant effect of time to surgery on outcome was reported in one (14.2%) of the seven studies targeting patients who underwent haematoma evacuation and in four (44.4%) of the nine studies on patients who underwent decompressive craniectomy.
  
  
  CONCLUSIONS
  This review shows that current opinion is still divided regarding when to operate. Despite this discrepancy, most authors agree that the timing of decompression is crucial to outcome.
authors.affiliation: Sungshin University, College of Nursing, Republic of Korea. Electronic address: yjkim727@sungshin.ac.kr.
authors.forename: Young-Ju
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D001930:Brain Injuries / Q000401:mortality / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000401:mortality; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000401:mortality / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Neurosurgery; Outcome; Review; Surgery; Time; Traumatic brain injury