Radiologic Findings and Patient Factors Associated with 30-Day Mortality after Surgical Evacuation of Subdural Hematoma in Patients Less Than 65 Years Old.
10.3340/jkns.2016.0404.009
- Author:
Myung Hoon HAN
1
;
Je Il RYU
;
Choong Hyun KIM
;
Jae Min KIM
;
Jin Hwan CHEONG
;
Hyeong Joong YI
Author Information
1. Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea. ryujeil@hanmail.net
- Publication Type:Original Article
- Keywords:
Subdural hematoma;
Traumatic brain injury;
Mortality;
Traumatic subarachnoid hemorrhage
- MeSH:
Brain Injuries;
Comorbidity;
Diabetes Mellitus;
Glasgow Coma Scale;
Hematoma, Subdural*;
Hematoma, Subdural, Acute;
Humans;
Methods;
Mortality*;
Prognosis;
Subarachnoid Hemorrhage, Traumatic;
Survival Rate
- From:Journal of Korean Neurosurgical Society
2017;60(2):239-249
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. METHODS: From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan–Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. RESULTS: We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52–0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27–4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20–4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27–3.58; p=0.005) were positively associated with 30-day mortality. CONCLUSION: We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.
