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New research · Emergency Medicine
Medical sciences (Basel, Switzerland) · 1w
Meta-analysisMedical sciences (Basel, Switzerland) · 2026

The Impact of Time-to-Intervention on Mortality and Functional Outcome in Acute Subdural Hematoma: A Systematic Review and Meta-Analysis.

Bogdan Jabłoński, Wojciech Górecki, Justyna Fercho … Mariusz Siemiński
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Emergency MedicineMeta-analysis

Time to surgery not associated with mortality in acute subdural hematoma

The Impact of Time-to-Intervention on Mortality and Functional Outcome in Acute Subdural Hematoma: A Systematic Review and Meta-Analysis.

Bogdan Jabłoński … Mariusz Siemiński
Medical sciences (Basel, Switzerland) · 2026
Background

Acute subdural hematoma (aSDH) represents one of the most lethal and debilitating forms of traumatic brain injury (traumatic brain injury) encountered in neurosurgical emergency settings, carrying high mortality rates and severe long-term functional deficits.

Methods

A systematic review was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO.

n = 1815 records
Results

chance of dying was about the same with earlier or later surgery

RR 1.01 (95% CI 0.69 to 1.48)
null = 10.691.48
CI crosses the null - not significant
More results

The search identified 1815 records, of which six studies, including 926 patients, met the inclusion criteria.

High statistical heterogeneity was observed (I 2 = 80%) across the included cohorts.

“
Conclusion · 1 of 2

While historical paradigms emphasize a 4h period for subdural hematoma evacuation, our meta-analysis indicates that a straightforward linear relationship between time to intervention and improved survival or functional outcome is absent in contemporary clinical studies.

Conclusion · 2 of 2

Surgical timing thresholds must be interpreted cautiously, as the decision-making process is heavily guided by clinical triage bias, where rapidly deteriorating patients are prioritized for urgent decompression.

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