Factors affecting the prognosis of traumatic acute subdural hematomas

Elhawary, Magdy A.; El Shokhaiby, Usama M.; Ali, Wafik E.; Gafar, Abdallah M.; Abd El Rahman, Ahmed A.

doi:10.4103/sjamf.sjamf_12_19

Factors affecting the prognosis of traumatic acute subdural hematomas

Authors

Abstract

Background
Trauma is the most frequent cause of young adult (under 45 years of age) fatalities worldwide, and traumatic brain injury accounts for up to 50% of these deaths. The incidence of traumatic brain injuries is increasing globally, largely due to an increase in motor vehicle use in low-income and middle-income countries.
Purpose
The aim of study was to investigate the factors that modulate the prognosis of patients with traumatic acute subdural hematoma.
Patients and methods
This study was conducted on 30 patients with acute traumatic subdural hematoma managed in the Department of Neurosurgery, ER, and Surgical ICU, Al-Azhar University Hospitals. All the data collected were statistically analyzed and the results were compared with the international results. Our recommendations were based on that comparison.
Results
Mortality rate was 53.3% (16 patients) in our study. The mean and SD of age in our study was 46.3±20.6 years. The range of age was 64 years (21–85 years). There was no statistical difference between sexes as regards age (=0.393). The entire study population was subjected to logistic regression analysis, severity of injury, presence of a secondary injury especially hypoxia or both hypoxia and hypotension. Polytrauma, status of conscious level at admission, anemia, thickness of hematoma, and necessity for endotracheal intubation were enrolled. The hypoxia and lower Glasgow coma scale at admission were found to be significant predictors of mortality.
Conclusion
Traumatic acute subdural hematoma still has a high mortality rate despite all developments in neurosurgical interventions. Initially low Glasgow coma scale and hypoxia are important parameters that correlate with the mortality rate.

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