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Predictive factors of 30‑day mortality in patients with traumatic subdural hematoma

  • Authors:
    • Iulia-Sevastiana Pastor
    • Lăcrimioara Perju Dumbravă
    • Costel Siserman
    • Horațiu Stan
    • Ioana Para
    • Ioan Ștefan Florian

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  • Published online on: May 13, 2021     https://doi.org/10.3892/etm.2021.10189
  • Article Number: 757
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Abstract

In the present study, we aimed to assess and analyze the predictive factors of 30‑day mortality in patients with acute subdural hematoma (ASDH) who underwent surgical intervention after traumatic brain injury (TBI). We conducted a retrospective study, which included a cohort of 135 consecutive patients diagnosed with ASDH who required surgical evacuation. We assessed the demographic and clinical data, the imaging data of the hematoma described by preoperative computed tomography (CT) and the type of neurosurgical intervention for hematoma evacuation via either craniectomy or craniotomy. The patients were followed up for 30 days after head trauma and the occurrence of death was noted. Death was recorded in 63 (46.6%) patients at 30 days after TBI. There was a significant number of deceased patients who underwent craniectomy (71.4%). The Glasgow Coma Scale (GCS) was statistically significantly lower in patients who died (P<0.001), with a cut‑off value of ≤12, under which the probability of death increased [AUC 0.830 (95% CI, 0.756‑0.889); Se 90.48% (95% CI, 80.4‑96.4); Sp 66.7% (95% CI, 54.6‑77.3); P<0.001]. The midline shift was statistically significantly higher in deceased patients (P=0.005), with a cut‑off value of >7 mm, over which the probability of death increased [AUC 0.637 (95% CI, 0.550‑0.718); Se 38.1% (95% CI, 26.1‑51.2); Sp 86.1% (95% CI, 75.9‑93.1); P=0.003]. There were significantly more deceased patients with intracranial hypertension, brain herniation, brain swelling, intraparenchymal hematoma and cranial fracture. In multivariate analysis only a Glasgow score ≤12 and a midline shift >7 mm were independently linked to mortality. Brain herniation and intraparenchymal hematoma were associated with a higher probability of dying, but the statistical threshold was slightly exceeded. The type of neurosurgery performed for patients with ASDH was not an independent predictive factor for 30‑day mortality. However, craniectomy was associated with a higher mortality in patients with ASDH.
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July-2021
Volume 22 Issue 1

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Spandidos Publications style
Pastor I, Dumbravă LP, Siserman C, Stan H, Para I and Florian IȘ: Predictive factors of 30‑day mortality in patients with traumatic subdural hematoma. Exp Ther Med 22: 757, 2021.
APA
Pastor, I., Dumbravă, L.P., Siserman, C., Stan, H., Para, I., & Florian, I.Ș. (2021). Predictive factors of 30‑day mortality in patients with traumatic subdural hematoma. Experimental and Therapeutic Medicine, 22, 757. https://doi.org/10.3892/etm.2021.10189
MLA
Pastor, I., Dumbravă, L. P., Siserman, C., Stan, H., Para, I., Florian, I. Ș."Predictive factors of 30‑day mortality in patients with traumatic subdural hematoma". Experimental and Therapeutic Medicine 22.1 (2021): 757.
Chicago
Pastor, I., Dumbravă, L. P., Siserman, C., Stan, H., Para, I., Florian, I. Ș."Predictive factors of 30‑day mortality in patients with traumatic subdural hematoma". Experimental and Therapeutic Medicine 22, no. 1 (2021): 757. https://doi.org/10.3892/etm.2021.10189