Predictors for Functional Recovery and Mortality of Surgically Treated Traumatic Acute Subdural Hematomas in 256 Patients

Kim, Kyu Hong

doi:10.3340/jkns.2009.45.3.143

Cited by 59 publications

(54 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several authors reported that older age is associated with a higher mortality for TBI (10,14,18,19,27,29,46). Our age data conflicts with prior studies.…”

contrasting

confidence: 56%

See 1 more Smart Citation

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

Gürer¹,

Kertmen²,

Yı́lmaz³

et al. 2015

Turkish Neurosurgery

View full text Add to dashboard Cite

ABSTRACTcommon clinical entities encountered by any neurosurgical service.Brain herniation due to posttraumatic hematoma remains one of the most difficult situation faced by neurosurgeons, and causes significant mortality and morbidity. To our knowledge there were only few past studies focused especially into the herniated subgroup of traumatic extraaxial hematomas (31,37,43,44).The aim of this retrospective study was to assess the surgical outcome and the prognostic importance of clinical and █ INTRODUCTION A ccident is the leading cause of death among individuals younger than 45 years. Traumatic brain injury (TBI) accounts for approximately 70% of these traumatic deaths and most of the unfavorable outcomes (2). The most important complication of TBI is the development of intracranial hematomas. It is estimated that intracranial hematomas occur in 25-45% of severe TBI, 3-12% of moderate cases and approximately 1 in 500 patients with mild TBI (40). As a result, acute traumatic extraaxial hematomas (epidural hematoma (EDH) and subdural hematoma (SDH)), are among the most AIm: The aim of this study was to assess the surgical outcome and the prognostic importance of clinical and radiological data of patients operated emergently for an extraaxial hematoma causing brain herniation. mATERIAl and mEThODS:This retrospective study comprised 108 adult patients who were operated due to herniated traumatic extraaxial hematomas from January 2000 to January 2013. RESUlTS:Of 108 patients, 63 patients (58.3%) were diagnosed as subdural hematoma (SDH), and 45 patients (41.7%) as epidural hematoma (EDH). An unfavorable outcome was significantly increased for patients who were diagnosed as SDH (90.4%) compared with EDH patients (33.3%). Mortality rate for herniated SDH patients was 65.1%, and 26.6% for herniated EDH patients. High mortality and unfavorable outcome ratios were associated with Glasgow Coma Scale scores at admission, mean postoperative intracranial pressure (ICP) values, type of the brain herniation, interval from the time of trauma to the time of hematoma decompression, the duration of the brain herniation, intraoperative acute brain swelling, hematoma volume and thickness, degree of the midline shift and the obliteration of the basal cisterns. CONClUSION:Our data showed that, postoperative ICP values were one most important predictor of the mortality. We recommended postoperative ICP monitoring for all patients presenting with the brain herniation due to traumatic extraaxial hematoma.

show abstract

“…Several authors reported that older age is associated with a higher mortality for TBI (10,14,18,19,27,29,46). Our age data conflicts with prior studies.…”

contrasting

confidence: 56%

“…Intraoperative acute brain swelling seems to be a strong predictor of poor outcome for the patients with TBI (18,24,41 …”

Section: █ Conclusionmentioning

confidence: 99%

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

Gürer¹,

Kertmen²,

Yı́lmaz³

et al. 2015

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…5,10,13,20 There may be underlying physiologic basis to account for the increased mortality observed with craniectomy. Removal of the bone segment allows for expansion of swollen brain through the defect leading to axonal stretch.…”

Section: Discussionmentioning

confidence: 99%

Craniotomy Versus Craniectomy for Acute Traumatic Subdural Hematoma in the United States: A National Retrospective Cohort Analysis

et al. 2016

View full text Add to dashboard Cite

“…13,35 However, current advances in imaging, rapid diagnostics, medical management of hemodynamic properties, and surgical techniques have improved patient outcomes, 36 and a further decrease in mortality associated with treatment for intracranial bleeding has been demonstrated; in 2008, postoperative mortality associated with craniotomy for evacuation of acute subdural and epidural hematoma ranged from 22% to 41%. 17,33,34 It is plausible that this overall decrease in mortality may also be reflected by improved survival among older patients. Given the breadth and scope of medical and surgical advancements, this raises an interesting and valuable question: Do older patients continue to suffer higher morbidity and mortality rates than younger patients following evacuation of intracranial hematoma and/or hemorrhage?…”

mentioning

confidence: 99%

Postoperative outcomes following closed head injury and craniotomy for evacuation of hematoma in patients older than 80 years

Lau

El-Sayed

Ziewacz

et al. 2012

JNS

View full text Add to dashboard Cite

Object Advances in the management of trauma-induced intracranial hematomas and hemorrhage (epidural, subdural, and intraparenchymal hemorrhage) have improved survival in these conditions over the last several decades. However, there is a paucity of research investigating the relation between patient age and outcomes of surgical treatment for these conditions. In this study, the authors examined the relation between patient age over 80 years and postoperative outcomes following closed head injury and craniotomy for intracranial hemorrhage. Methods A consecutive population of patients undergoing emergent craniotomy for evacuation of intracranial hematoma following closed head trauma between 2006 and 2009 was identified. Using multivariable logistic regression models, the authors assessed the relation between age (> 80 vs ≤ 80 years) and postoperative complications, intensive care unit stay, hospital stay, morbidity, and mortality. Results Of 103 patients, 27 were older than 80 years and 76 patients were 80 years of age or younger. Older age was associated with longer length of hospital stay (p = 0.014), a higher rate of complications (OR 5.74, 95% CI 1.29–25.34), and a higher likelihood of requiring rehabilitation (OR 3.28, 95% CI 1.13–9.74). However, there were no statistically significant differences between the age groups in 30-day mortality or ability to recover to functional baseline status. Conclusions The findings suggest that in comparison with younger patients, patients over 80 years of age may be similarly able to return to preinjury functional baselines but may require increased postoperative medical attention in the forms of rehabilitation and longer hospital stays. Prospective studies concerned with the relation between older age, perioperative parameters, and postoperative outcomes following craniotomy for intracranial hemorrhage are needed. Nonetheless, the findings of this study may allow for more informed decisions with respect to the care of elderly patients with intracranial hemorrhage.

show abstract

Predictors for Functional Recovery and Mortality of Surgically Treated Traumatic Acute Subdural Hematomas in 256 Patients

Cited by 59 publications

References 35 publications

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

Craniotomy Versus Craniectomy for Acute Traumatic Subdural Hematoma in the United States: A National Retrospective Cohort Analysis

Postoperative outcomes following closed head injury and craniotomy for evacuation of hematoma in patients older than 80 years

Contact Info

Product

Resources

About