Outcome and survival of surgically treated acute subdural hematomas and postcraniotomy hematomas - A retrospective cohort study.
Acute subdural hematoma
Outcome
Postcraniotomy hematoma
Surgery
Survival
Traumatic brain injury
Journal
Brain & spine
ISSN: 2772-5294
Titre abrégé: Brain Spine
Pays: Netherlands
ID NLM: 9918470888906676
Informations de publication
Date de publication:
2023
2023
Historique:
received:
07
09
2023
revised:
13
11
2023
accepted:
17
11
2023
medline:
18
12
2023
pubmed:
18
12
2023
entrez:
18
12
2023
Statut:
epublish
Résumé
The morbidity and mortality of acute subdural hematoma (aSDH) remains high. Several factors have been reported to affect the outcome and survival of these patients. In this study, we explored factors potentially associated with the outcome and survival of surgically treated acute subdural hematoma (aSDH), including postcraniotomy hematomas (PCHs). This retrospective cohort study was conducted in a single tertiary university hospital between 2008 and 2012 and all aSDH patients that underwent surgical intervention were included. A total of 132 cases were identified for collection of demographics, clinical, laboratory, and imaging data. Univariate and multivariable analyses were performed to assess factors associated with three-month Glasgow Outcome Scale (GOS) and survival at one- and five-year. In this study, PCH (n = 14, 10.6%) was not associated with a worse outcome according to the 3- month GOS (p = 0.37) or one (p = 0.34) and five-year (p = 0.37) survival. The multivariable analysis showed that the volume of initial hematoma (p = 0.009) and Abbreviated Injury Scale score (p = 0.016) were independent predictors of the three-month GOS. Glasgow Coma Scale (GCS) score (p < 0.001 and p = 0.037) and age (p = 0.048 and p = 0.003) were predictors for one and five-year survival, while use of antiplatelet drug (p = 0.030), neuroworsening (p = 0.005) and smoking (p = 0.026) were significant factors impacting one year survival. In addition, blood alcohol level on admission was a predictor for five-year survival (p = 0.025). These elucidations underscore that, although PCHs are pertinent, a comprehensive appreciation of multifarious variables is indispensable in aSDH prognosis. These findings are observational, not causal. Expanded research endeavors are advocated to corroborate these insights.
Sections du résumé
Background
UNASSIGNED
The morbidity and mortality of acute subdural hematoma (aSDH) remains high. Several factors have been reported to affect the outcome and survival of these patients. In this study, we explored factors potentially associated with the outcome and survival of surgically treated acute subdural hematoma (aSDH), including postcraniotomy hematomas (PCHs).
Methods
UNASSIGNED
This retrospective cohort study was conducted in a single tertiary university hospital between 2008 and 2012 and all aSDH patients that underwent surgical intervention were included. A total of 132 cases were identified for collection of demographics, clinical, laboratory, and imaging data. Univariate and multivariable analyses were performed to assess factors associated with three-month Glasgow Outcome Scale (GOS) and survival at one- and five-year.
Results
UNASSIGNED
In this study, PCH (n = 14, 10.6%) was not associated with a worse outcome according to the 3- month GOS (p = 0.37) or one (p = 0.34) and five-year (p = 0.37) survival. The multivariable analysis showed that the volume of initial hematoma (p = 0.009) and Abbreviated Injury Scale score (p = 0.016) were independent predictors of the three-month GOS. Glasgow Coma Scale (GCS) score (p < 0.001 and p = 0.037) and age (p = 0.048 and p = 0.003) were predictors for one and five-year survival, while use of antiplatelet drug (p = 0.030), neuroworsening (p = 0.005) and smoking (p = 0.026) were significant factors impacting one year survival. In addition, blood alcohol level on admission was a predictor for five-year survival (p = 0.025).
Conclusions
UNASSIGNED
These elucidations underscore that, although PCHs are pertinent, a comprehensive appreciation of multifarious variables is indispensable in aSDH prognosis. These findings are observational, not causal. Expanded research endeavors are advocated to corroborate these insights.
Identifiants
pubmed: 38105801
doi: 10.1016/j.bas.2023.102714
pii: S2772-5294(23)01002-0
pmc: PMC10724206
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102714Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Janne Koskimaki reports financial support was provided by Maire Taponen Foundation. Janne Koskimaki reports financial support was provided by Sigrid Jusélius Foundation. Janne Koskimaki reports financial support was provided by 10.13039/100010135Finnish Medical Association. Janne Koskimaki reports financial support was provided by 10.13039/100010129Maud Kuistila Memorial Foundation. Iiro Heino reports financial support was provided by Sigrid Jusélius Foundation. Antti Sajanti reports financial support was provided by Sigrid Jusélius Foundation. Antti Sajanti reports financial support was provided by Maire Taponen Foundation. Jussi Posti reports financial support was provided by 10.13039/501100002341Academy of Finland.