title: Surgical management of acute subdural haematomas in elderly: report of a single center experience.
abstract: OBJECTIVE
  To evaluate the clinical outcome of patients over 70 years old who have received surgical treatment for traumatic acute subdural haematoma (aSDH) in our Neurosurgical Department. We also disclose related surgical and medical costs.
  
  
  METHODS
  A retrospective analysis was performed by analyzing the medical records of patients older than 70 who had undergone surgery for evacuation of traumatic aSDH between June 2011 and December 2014. Through univariate and multivariate analyses, we correlated clinical and radiological pre-operatory features with outcome at one and six months after surgery. Overall costs for each patient were recorded.
  
  
  RESULTS
  We observed 67 patients, 36 male and 31 female, with a median age of 80.5 years old (range 71-94). The mortality rate at one month and six months after surgery was respectively 55.1% and 67.2% while functional recovery was respectively 10.4% and 13.4%. Multivariate analysis age and Glasgow Coma Score (GCS) are the most significant parameters in relation to clinical outcome. Age greater than 90, shift midline >20 mm and volume of the haematoma >200 cu cm were independent parameters to predict mortality within 10 days of surgery.
  
  
  CONCLUSIONS
  Our study confirms a poor outcome for patients of 70 years and over who received surgical treatment for traumatic aSDH.
authors.affiliation: a Department of Neurosurgery , AOUP , Pisa , Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Benedetto
authors.affiliation: a Department of Neurosurgery , AOUP , Pisa , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Gambacciani
authors.affiliation: a Department of Neurosurgery , AOUP , Pisa , Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Montemurro
authors.affiliation: b Department of Clinical & Experimental Medicine, Section of Statistics , University of Pisa , Pisa , Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Morganti
authors.affiliation: a Department of Neurosurgery , AOUP , Pisa , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Perrini
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D020199:Hematoma, Subdural, Acute / Q000191:economics / Q000401:mortality / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000191:economics / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications
keywords: Elderly; acute subdural haematoma; functional recovery; mortality; outcome