Radiologic Findings and Patient Factors Associated with 30-Day Mortality after Surgical Evacuation of Subdural Hematoma in Patients Less Than 65 Years Old

Han, Myung‐Hoon; Ryu, Je Il; Kim, Choong Hyun; Kim, Jae Min; Cheong, Jin Hwan; Yi, Hyeong-Joong

doi:10.3340/jkns.2016.0404.009

Cited by 5 publications

(19 citation statements)

References 31 publications

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“…These studies were penalised because of biases on multiple levels, four or more out of seven criteria of biases. A total of 2722–48 studies, all of ‘moderate’ quality, were included for data analysis (figure 1).…”

Section: Resultsmentioning

confidence: 99%

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Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

et al. 2019

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ObjectivesComorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.DesignSystematic review.Data sourcesMedline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studiesIncluded studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time.Data extraction and synthesisTwo independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description.ResultsA total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality.ConclusionsGiven the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment.PROSPERO registration numberCRD42017070033

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Section: Resultsmentioning

confidence: 99%

“…A summary of the included studies is presented in Table 1, online supplementary tables 3 and 4. Among the 27 studies, 14 were population based23 25 26 28 29 33–37 40 41 44 45 and 13 were clinical studies 22 24 27 30–32 38 39 42 43 46–48. Of the 14 population-based studies, all but one used a retrospective cohort design 29.…”

Section: Resultsmentioning

confidence: 99%

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

et al. 2019

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“…Many studies stated that the outcome of severe head injury patients with ASDH was mostly poor but with a percentage of a good outcome [3,4,[7][8][9]. These studies stated the overall outcome of all the severe head injury patients without subgrouping analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, traumatic acute subdural hematoma (ASDH) results in high mortality despite intensive treatment [1,2]. It is commonly associated with brain edema, subarachnoid hemorrhage, brain contusions, and diffuse axonal injury, and all affect the neurological outcome [3,4].…”

Section: Introductionmentioning

confidence: 99%

Prognosis of acute subdural hematoma greater than 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation

AbdelFatah

2019

Egypt J Neurosurg

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Background: Most of the studies that examined the prognosis of acute subdural hematoma (ASDH) in severe head injury patients stated their overall prognosis as one group. The aim of the present study was to assess the prognosis of ASDH of > 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation. Material and methods: This retrospective study reviewed the severe head injury patients admitted to our university hospitals from January 2014 to August 2017. The inclusion criteria were the patients with an extension or no motor response to pain after resuscitation with an ASDH > 10 mm in thickness and a midline shift > 5 mm in the initial head computed tomography (CT) scan. Two hundred six patients met the inclusion criteria of this study. Their mean age was 42.3 years. One hundred forty-two patients (68.9%) were males. Results: The mean duration between trauma and admission was 41 min. Sixty-two patients (30%), including 38 anonymous patients, were surgically managed and the remainder were managed conservatively. All patients (100%) died in the intensive care unit within 1 month after trauma. Conclusion: This study emphasized that both surgical and conservative management of ASDH had similar dismal results and that there was no additional benefit from surgical intervention in the studied group of head injury patients. Randomized controlled trials are needed to set a standard of care for the management of ASDH in this subgroup of the severe head injury patients.

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“…The pressure imposed on the cerebral tissue by a hematoma is not the only factor that affects neurological outcomes, because ASDH is commonly associated with brain edema, contusions, and diffuse axonal injury (DAI) 1,6,7) . This can increase midline shift (MLS) and make hematoma removal inappropriate for satisfactory patient outcomes 8,9) .…”

Section: Introductionmentioning

confidence: 99%

Risk Stratification in Patients with Severe Traumatic Acute Subdural Hematoma

Lee

Song

Choe

et al. 2017

Nerve

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The aim of this study was to investigate risk grouping for surgical outcome in patients with severe traumatic acute subdural hematoma (ASDH). Methods: Seventy-five patients showing low Glasgow Coma Scale (GCS) 3 to 8 were enrolled in this retrospective study. Clinico-radiologic findings were retrieved from electronic medical record and computed tomography. Prognostic factors from univariate and multivariate statistical methodology were included in a recursive partitioning analysis for risk stratification. Results: One month after surgery, 54 patients (72%) had poor Glasgow Outcome Scale (GOS) 1 to 2 (unfavorable outcome). The surgical outcomes were stratified into three homogenous risk groups according to preoperative GCS and presence of basal cistern obliteration. The rate of favorable outcome and mortality significantly differ between the groups: 4.9% and 68.3% in patients with GCS 3 to 5, 23.1% and 53.8% in patients with GCS 6 to 8 and basal cistern obliteration, and 76.2% and 0% in patients with GCS 6 to 8 and without basal cistern obliteration. Conclusion: The surgical outcomes of severe traumatic ASDH patients could be stratified preoperative GCS score and the presence of basal cistern obliteration. It is expected that this model will not only provide objective information when we make decisions about treatment, but it can also be a useful tool when discussing the patient's prognosis with the patient's caregivers.

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Radiologic Findings and Patient Factors Associated with 30-Day Mortality after Surgical Evacuation of Subdural Hematoma in Patients Less Than 65 Years Old

Cited by 5 publications

References 31 publications

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

Prognosis of acute subdural hematoma greater than 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation

Risk Stratification in Patients with Severe Traumatic Acute Subdural Hematoma

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