Citation

Ryan CG, Thompson RE, Temkin NR, Crane PK, Ellenbogen RG, Elmore JG. J. Trauma Acute Care Surg. 2012; 73(5): 1348-1354.

Affiliation

From the Departments of Medicine (C.G.R., R.E.T., P.K.C., J.G.E.) and Neurological Surgery (C.G.R., R.E.T., N.R.T., R.G.E.), School of Medicine, and Departments of Epidemiology (J.G.E.) and Biostatistics (N.R.T.), School of Public Health, University of Washington, Seattle, Washington.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e31826fcb30

PMID

23117390

Abstract

BACKGROUND: Existing data on outcomes following subdural hematoma have provided limited information on medical complications and functional outcomes. Mortality rates previously reported range from 22% to 66%. METHODS: This is a retrospective cohort study of prospectively collected data from a trauma registry in Washington State from 2005 through 2008. Patients were categorized by surgical evacuation status with the hypothesis that those undergoing evacuation represented a more severe injury. RESULTS: The 1,427 patients included in the study had a mean age of 58 years, and most of them were male (63%). Glasgow Coma Scale (GCS) score on presentation was greater than 12 in 58%; the average Injury Severity Score (ISS) was 27.5. Mean length of stay was 9.6 days (range, 1-110), with 40% spending 2 or more days in the intensive care unit. Twenty-eight percent experienced medical complications. At discharge, 94% had GCS score of 13 or greater. Independence with expression, feeding, and locomotion at discharge was noted for 92%, 81%, and 43%, respectively. Inpatient mortality was 16% and did not differ significantly between the evacuated group (15%) and the nonevacuated group (17%). CONCLUSION: This large cohort of patients with acute traumatic subdural hematoma demonstrated a lower mortality rate than those of previous reports, including among patients requiring surgical evacuation (J Trauma Acute Care Surg. 2012;73:1348-1352). LEVEL OF EVIDENCE: Epidemiologic study, level III.

Language: en