Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System

Abstract

ObjectiveThe aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS).MethodsOf 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes. Various clinical characteristics and the time intervals with regard to treatment course were investigated to determine the relationship between these parameters and the functional outcome.ResultsOf multiple parameters for this analysis, older age (p=0.0003), higher degree of brain injury (p<0.0001), cases of surgical EDH (p<0.0001), time interval from trauma to hospital before 6 hours, and the decreasing pattern of Glasgow Coma Scale (GCS) between and initial and final GCS were strongly associated with poor outcome. Use of prophylactic anticonvulsant did not affect the functional outcome. There was an interesting difference in the use of mannitol in treating EDH between the urban and rural regions (p<0.0001).ConclusionThis is the first multi-center analysis of etiology of injury, pre-hospital care, treatment, and functional outcome of EDH in Korea. The degree of brain injury and the GCS difference were notable factors that were significant in determining the functional outcome of EDH.

Mortality Influenced Factors for Outcome of Epidural Hematoma Patient Which Performed Emergency Craniotomy in M Djamil Hospital Padang Periode January-December 2017

“…The characteristics of inisial GCS, gender, pupil abnormality, waiting duration, and trauma onset did not differ significantly between treatment and control groups ( Table 1). 8 In this study, it was found that the mean of age of EDH patients was 25+12.75 years in the treatment group and 21.73+14.83 years in the control group. Taussky et al pointed that craniotomy procedure in younger age groups delivered more favorable outcome.…”

“…10 Study by Jeong et al exhibited favorable outcome in mild brain injury at 71.26%, followed by moderate brain injury at 22.27%, and severe brain injury at 6.48%. 8 The mean duration of waiting time in this study for the treatment group was 7.53+4.14 hours with trauma onset of 17.67+14.53 hours, while the control group was 6.07+1.44 hours, with trauma onset of 20.4+18.47 hours. According to study conducted by Jeong et al favorable outcome was at 79.18% if the duration of waiting time was <6 hours and 20.82% for >6 hours.…”

“…According to study conducted by Jeong et al favorable outcome was at 79.18% if the duration of waiting time was <6 hours and 20.82% for >6 hours. 8 In the study of Taussky et al there was no significant difference on the outcome of EDH patients who underwent emergency craniotomy with time interval of <3 hours and >3 hours. 9 Study by Niryana et al stated that the duration of waiting time <12 hours yielded higher favorable outcome by 61.7%, compared to >12 hours by 10%.…”

“…In addition, different types of brain injury result in multiple subdivisions of inconstant consequences. 8 As the population ages with longer life expectancy, trends of injury have also been changing with more injuries in geriatric population. As well as we have already witnessed in the analysis of our database, age is the major determinant of functional outcome.…”

Surgical Outcome of Isolated Extradural Hematomas Operated in a Teaching Hospital in Western Nepal

“…However, Jeong YH showed that older age, higher degree of brain injury, surgical cases of extradural hematomas, decreasing pattern of coma scale between initial and fi nal coma scale were prognostic factors in patients with extradural hematomas. 7 Majority of patients with extradural hematomas have favorable outcome following surgery. At one month follow up almost 90% of patients had favorable outcome, 84.05% had good recovery and 9.57% had moderate disability.…”