title: Acute traumatic subdural hematoma: current mortality and functional outcomes in adult patients at a Level I trauma center.
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%).
  
  
  CONCLUSIONS
  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).
  
  
  METHODS
  Epidemiologic study, level III.
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Christina G
authors.initials: CG
authors.lastname: Ryan
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Thompson
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Temkin
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.forename: Richard G
authors.initials: RG
authors.lastname: Ellenbogen
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006408:Hematoma, Subdural / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D014193:Trauma Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014861:Washington; D055815:Young Adult