Parkinsonism and dementia are negative prognostic factors for the outcome of subdural hematoma.
To determine, among a population with subdural hematoma (SH), whether patients affected by neurodegenerative disorders (parkinsonism and dementia) have a worse clinical outcome. We reviewed the data of patients diagnosed with fall-related SH discharged from the Departments of Neurology/Stroke unit, Neurosurgery, Intensive Care Unit at Brotzu General Hospital (Cagliari, Italy) between January 2010 and December 2013. Patients with severe traumatisms, evidence of spontaneous intracerebral bleeding or aged less than 50 were excluded. 332 patients were selected: 69 with a neurodegenerative parkinsonism or dementia (N-group), 217 with history of chronic non-neurological medical conditions with significant disability, previous falls and/or balance problems (NND-group) and 46 with a history of "minor" chronic non-neurological disorder. (NN-group). The clinical status at admission and discharge was assessed by modified Rankin Scale (mRS). The time-span between trauma and hospital admission was also calculated. At hospital admission we found a significantly longer delay in SH's diagnosis (χ (2) test p < 0.001) and a worse mRS score (Kruskal Wallis p < 0.001) in the N-group compared to both NN and NND-groups. During hospital stay we observed the lack of significant variation in mRS score in N-group (Wilcoxon test p = 0.86), in contrast with NN and NND-groups who significantly improved (Wilcoxon test p < 0.001). Our results demonstrate that the consequences of SH are more severe in the N-group compared to NN and NND-groups. The longer interval between trauma and hospital admittance plays a critical role in worsening the outcome of patients with parkinsonism and dementia compared to subjects without neurodegenerative disorders.
Neurology Service and Stroke Unit, Department of Neuroscience, AOB "G. Brotzu" General Hospital, P.le Ricchi, 1, 09134, Cagliari, Italy.
Roberta
R
Arca
Neurology Service and Stroke Unit, Department of Neuroscience, AOB "G. Brotzu" General Hospital, P.le Ricchi, 1, 09134, Cagliari, Italy.
Valeria
V
Ricchi
Neurology Service and Stroke Unit, Department of Neuroscience, AOB "G. Brotzu" General Hospital, P.le Ricchi, 1, 09134, Cagliari, Italy.
Daniela
D
Murgia
Department of Neurology, Azienda Universitario Ospedaliera di Cagliari, University of Cagliari, Cagliari, Italy.
Marta
M
Melis
Neurosurgery Unit, Department of Neuroscience, AO Brotzu, Cagliari, Italy.
Francesco
F
Floris
Department of Public Health, University of Cagliari, Cagliari, Italy.
Alessandra
A
Mereu
Department of Public Health, University of Cagliari, Cagliari, Italy.
Paolo
P
Contu
Department of Neurology, Azienda Universitario Ospedaliera di Cagliari, University of Cagliari, Cagliari, Italy.
Francesco
F
Marrosu
Neurology Service and Stroke Unit, Department of Neuroscience, AOB "G. Brotzu" General Hospital, P.le Ricchi, 1, 09134, Cagliari, Italy.
Maurizio
M
Melis
Neurology Service and Stroke Unit, Department of Neuroscience, AOB "G. Brotzu" General Hospital, P.le Ricchi, 1, 09134, Cagliari, Italy. giovannicossu1@gmail.com.
Giovanni
G
Cossu
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000209:etiology*; D005260:Female; D006408:Hematoma, Subdural / Q000150:complications* / Q000175:diagnosis*; D006760:Hospitalization; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020734:Parkinsonian Disorders / Q000209:etiology*; D010351:Patient Discharge; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
Dementia; Falls; Outcome; Parkinsonism; Subdural hematoma