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 journalArticle

30 Citations (Scopus)

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 1 2012

Fingerprint

Hematoma, Subdural, Acute
Subdural Hematoma
Trauma Centers
Glasgow Coma Scale
Mortality
Wounds and Injuries
Injury Severity Score
Locomotion
Intensive Care Units
Registries
Inpatients
Epidemiologic Studies
Length of Stay
Cohort Studies
Retrospective Studies

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Acute traumatic subdural hematoma : Current mortality and functional outcomes in adult patients at a Level i trauma center. / Ryan, Christina G.; Thompson, Rachel E; Temkin, Nancy R.; Crane, Paul K.; Ellenbogen, Richard G.; Elmore, Joann G.

In: Journal of Trauma and Acute Care Surgery, Vol. 73, No. 5, 01.11.2012, p. 1348-1353.

Research output: Contribution to journalArticle

Ryan, Christina G. ; Thompson, Rachel E ; Temkin, Nancy R. ; Crane, Paul K. ; Ellenbogen, Richard G. ; Elmore, Joann G. / Acute traumatic subdural hematoma : Current mortality and functional outcomes in adult patients at a Level i trauma center. In: Journal of Trauma and Acute Care Surgery. 2012 ; Vol. 73, No. 5. pp. 1348-1353.
@article{5a82544572d24a6fb6cb130f58ce6888,
title = "Acute traumatic subdural hematoma: Current mortality and functional outcomes in adult patients at a Level i trauma center",
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.",
keywords = "Acute subdural hematoma, Mortality, Subdural hematoma, Traumatic brain injury",
author = "Ryan, {Christina G.} and Thompson, {Rachel E} and Temkin, {Nancy R.} and Crane, {Paul K.} and Ellenbogen, {Richard G.} and Elmore, {Joann G.}",
year = "2012",
month = "11",
day = "1",
doi = "10.1097/TA.0b013e31826fcb30",
language = "English (US)",
volume = "73",
pages = "1348--1353",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Acute traumatic subdural hematoma

T2 - Current mortality and functional outcomes in adult patients at a Level i trauma center

AU - Ryan, Christina G.

AU - Thompson, Rachel E

AU - Temkin, Nancy R.

AU - Crane, Paul K.

AU - Ellenbogen, Richard G.

AU - Elmore, Joann G.

PY - 2012/11/1

Y1 - 2012/11/1

N2 - 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.

AB - 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.

KW - Acute subdural hematoma

KW - Mortality

KW - Subdural hematoma

KW - Traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=84869814632&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869814632&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e31826fcb30

DO - 10.1097/TA.0b013e31826fcb30

M3 - Article

VL - 73

SP - 1348

EP - 1353

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 5

ER -