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All Journal Saintika Medika: Jurnal Ilmu Kesehatan dan Kedokteran Keluarga.
Yuddy Imowanto
Brawijaya University
Health Professions Medicine & Pharmacology Public Health

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Association Between Admission-to-Surgery Time and Outcomes in Traumatic Brain Injury at RSSA Yuddy Imowanto; Holipah; Sri Wahyuni
Saintika Medika : Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol. 22 No. 1 (2026): June 2026
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/sm.Vol22.SMUMM1.44390

Abstract

Despite evidence that streamlined trauma protocols reduce preoperative delays and improve survival, delays from emergency department admission to surgical intervention remain common and are associated with poorer outcomes. Although international guidelines recommend decompression within a four-hour “golden period,” data on adherence in Indonesia remain limited. This retrospective cohort study evaluated 91 patients with traumatic brain injury (TBI) who underwent neurosurgical intervention at Saiful Anwar Hospital, Malang, between 2023 and 2024. The association between preoperative time intervals and clinical outcomes, including mortality, Glasgow Outcome Scale at hospital discharge (GOS-HD), and length of stay (LOS), was analyzed. Admission-to-surgery time was not significantly associated with mortality (p = 0.725) or GOS-HD (p = 0.648). However, prolonged total time to surgery (p = 0.029) and extended CT-to-surgery intervals (p = 0.026) were significantly associated with increased LOS. These findings indicate that while surgical delays may not directly affect short-term survival or functional outcomes, they contribute to longer hospitalization and reduced care efficiency. Efforts to minimize post-CT delays may improve workflow and optimize trauma care delivery.
Emergency Department Length of Stay Prior to Surgery in Head Injury Patients Suryanto Eko Agung Nugroho; Tita Hariyanti; Taufiq Abdullah; Yuddy Imowanto; Dewi Puspitasari
Saintika Medika : Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol. 22 No. 1 (2026): June 2026
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/sm.Vol22.SMUMM1.44440

Abstract

Preoperative delays in traumatic brain injury (TBI) significantly increase morbidity and mortality. While general emergency department (ED) crowding is well-documented, specific bottlenecks bridging ED admission to neurosurgical intervention remain underexplored. This study identifies primary determinants prolonging ED length of stay (LOS) for preoperative TBI patients, offering a novel perspective on systemic versus clinical delays. This retrospective cohort study evaluated 102 head injury patients requiring emergency surgery at Dr. Saiful Anwar Hospital from January 2024 to June 2025. Mean ED LOS was 575.5 minutes (≈9.6 hours). Multivariate linear regression showed that prolonged boarding time and extended diagnostic durations were primary predictors of increased LOS (P < 0.05). Conversely, clinical factors like triage priority and staffing ratios did not significantly influence stay duration (P > 0.05). Notably, boarding time was the most dominant factor, accounting for 40.6% of LOS variance (R² = 0.406). These findings indicate that systemic operational inefficiencies in preoperative waiting and diagnostic workflows are more critical drivers of delay than patient acuity. Consequently, hospital management should prioritize optimizing inter-departmental coordination and emergency surgical pathways to improve outcomes for head injury patients.
Co-Authors Dewi Puspitasari Holipah Sri Wahyuni Suryanto Eko Agung Nugroho Taufiq Abdullah Tita Hariyanti