Acute traumatic subdural hematoma: Current mortality and functional outcomes in adult patients at a Level i trauma center

Christina G. Ryan, Rachel E. Thompson, Nancy R. Temkin, Paul K. Crane, Richard G. Ellenbogen, Joann G. Elmore

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

BACKGROUND: Existing data on outcomes following subdural hematoma have provided limited information on medical complications and functional outcomes. Mortality rates previously reported range from 22% to 66%. METHODS: This is a retrospective cohort study of prospectively collected data from a trauma registry in Washington State from 2005 through 2008. Patients were categorized by surgical evacuation status with the hypothesis that those undergoing evacuation represented a more severe injury. RESULTS: The 1,427 patients included in the study had a mean age of 58 years, and most of them were male (63%). Glasgow Coma Scale (GCS) score on presentation was greater than 12 in 58%; the average Injury Severity Score (ISS) was 27.5. Mean length of stay was 9.6 days (range, 1-110), with 40% spending 2 or more days in the intensive care unit. Twenty-eight percent experienced medical complications. At discharge, 94% had GCS score of 13 or greater. Independence with expression, feeding, and locomotion at discharge was noted for 92%, 81%, and 43%, respectively. Inpatient mortality was 16% and did not differ significantly between the evacuated group (15%) and the nonevacuated group (17%). CONCLUSION: This large cohort of patients with acute traumatic subdural hematoma demonstrated a lower mortality rate than those of previous reports, including among patients requiring surgical evacuation (J Trauma Acute Care Surg. 2012;73:1348-1352). LEVEL OF EVIDENCE: Epidemiologic study, level III.

Original languageEnglish (US)
Pages (from-to)1348-1353
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume73
Issue number5
DOIs
StatePublished - Nov 2012

Keywords

  • Acute subdural hematoma
  • Mortality
  • Subdural hematoma
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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