Risk factors related to hospital mortality in patients with isolated traumatic acute subdural haematoma: analysis of 308 patients undergone surgery.
BACKGROUND
Acute subdural haematoma (ASDH) is a common traumatic brain injury with a relatively high mortality rate. However, few studies have examined the factors predicting the outcome of isolated traumatic ASDH. This clinical study examined the hospital mortality and analyzed the risk factors for mortality in patients treated surgically for isolated traumatic ASDH.


METHODS
We collected 308 consecutive patients who underwent neurosurgery for isolated traumatic ASDH between January 1999 and December 2007 and used multivariate Logistic regression analysis to evaluate the influence of 11 clinical variables on hospital mortality.


RESULTS
The overall hospital mortality was 21.75% (67/308). Age (OR = 1.807), preoperative Glasgow Coma Score (OR = 0.316), brain herniation (OR = 2.181) and the time from trauma to decompression (OR = 1.815) were independent predictors of death, while no independent association was observed between hospital mortality and haematoma volume, midline shift, acute brain swelling or brain herniation duration, although these variables were correlated with hospital mortality in univariate analyses.


CONCLUSIONS
This study identified the risk factors for hospital mortality in patients who underwent surgical treatment for isolated traumatic ASDH. An increased risk of death occurs in patients who are over 50 years of age and have lower preoperative Glasgow Coma Scores, the presence of brain herniation and a long interval between trauma and decompression. The findings should help clinicians determine management criteria and improve survival.
Tian
Heng-li
HL
Department of Neurosurgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
Chen
Shi-wen
SW
Xu
Tao
T
Hu
Jin
J
Rong
Bo-ying
BY
Wang
Gan
G
Gao
Wen-wei
WW
Chen
Hao
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome