Factors Associated with Delayed Intracranial Hemorrhage in Trauma Patients : A Retrospective Study at a Level I Trauma Center
- Author:
Juhong PARK
1
;
Namkyu YOO
;
Byung Hee KANG
Author Information
- Publication Type:Clinical Article
- From:Journal of Korean Neurosurgical Society 2026;69(1):135-141
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:: The indications for repeated brain computed tomography (CT) for delayed intracranial hemorrhage (DICH) remain inconclusive. This study aimed to identify the risk factors for DICH in patients with severe trauma.
Methods:: Patients with blunt trauma, admitted to a level I trauma center between January 2018 and June 2020, were retrospectively reviewed. Patients who underwent repeat brain CT but had a normal initial brain CT were included. The patients were divided into the DICH and normal groups, and their general characteristics and outcomes were compared. Multi-logistic regression analysis was performed to identify the risk factors. Patients with DICH were also interviewed.
Results:: Of 784 patients, 37 (4.7%) were included in the DICH group. The DICH group presented with more severe injury. In multi-logistic regression, age over 65 years (odds ratio [OR], 2.681; 95% confidence interval [CI], 1.250–5.753; p=0.011), lowest systolic blood pressure under 90 mmHg during resuscitation (OR, 2.678; 95% CI, 1.247–5.750; p=0.012), severe abdominal injury (OR, 2.667; 95% CI, 1.213–5.864; p=0.015) and cervical spine fracture (OR, 2.408; 95% CI, 1.084–5.351; p=0.031) were associated with DICH. Among the 37 patients with DICH, one patient underwent an invasive procedure, and no mortality was reported.
Conclusion:: The incidence of DICH may be higher in patients with severe trauma and repeat brain CT could be considered in selected high-risk cases, even when the initial scan is normal.
