457 Timing of Surgery as an Outcome Predictor in Brachial Plexus Injury: A Systematic Review and Meta-Analysis

Abstract

INTRODUCTION: Injuries that affect the brachial plexus are considered to have a high impact on the quality of life of patients. Brachial plexus injuries in adults require reconstruction using microsurgical techniques. At least, there is still controversy about the impact of the timing of surgical reconstruction and its effect on outcome. METHODS: We searched PubMed, EMBASE, Cochrane Library, SCOPUS, and MEDLINE, up to March 2023, for published studies on evidence of timing of surgery in Brachial plexus injury and neurological outcome. Primary outcome Good motor functional Recovery (MRC). RESULTS: In this meta-analysis, it was found that early surgical treatment before 6 months post-injury increases motor recovery (MRC) three times more than late intervention (after 6 months) with adequate statistical significance and good homogeneity (OR 3,115 [95% CI 2,248–4,317] p = <0.0001; I2 = <0.00001%). CONCLUSIONS: The available evidence suggests that performing brachial plexus surgery in less than 6 months can be associated with a better outcome. Further research is needed to characterize various subgroups of BPI patients. It is necessary to improve the quality of the evidence, so we suggest the creation of a multicenter database in the United States that allows us to obtain better conclusions.