Surgical evacuation of acute subdural hematoma in octogenarians: a ten-year experience from a single trauma center.
Br J Neurosurg
; 31(6): 714-717, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28618921
ABSTRACT
BACKGROUND:
Elderly patients presenting with an acute subdural hematoma (aSDH) have historically had unfavorable outcomes.METHODS:
We retrospectively reviewed patient records from 2005 through 2015 that were ≥80 years of age and underwent surgical evacuation of aSDH.RESULTS:
Thirty-four patients met inclusion criteria, with a mean age of 84 years (range 80-91). Glascow Outcome Scale (GOS) of 4-5 was deemed a good outcome and a GOS 1-3 was deemed to be a poor outcome. Six patients had good outcome at last follow up and 27 patients had poor outcome. Patients with a higher presenting Glascow Coma Scale (GCS) trended towards better outcome [(good mean 13.1, median 14.5, IQR 12.5-15) vs. (poor mean 9.6, median 10, IQR 6-14) p = 0.06]. Patients with a higher in-hospital post-operative GCS score had significantly better overall outcome than patients who left the hospital with a lower GCS score [(good mean 14.5, median 14.5, IQR 14-15) vs. (poor mean 8.4, median 9, IQR 4-11) p = 0.001]. Patients with a good outcome had a median aSDH thickness of 17mm (IQR 12.75-19.75) while patients with a poor outcome had a median thickness of 20mm (IQR 16-24.5); p = 0.17. In addition, patients with a good outcome had a median midline shift of 10mm (IQR 6-12.5), while patients with a poor outcome had a median midline shift of 14mm (IQR 10-20); p = 0.07.CONCLUSIONS:
The prognosis for elderly patients with large aSDH remains poor, but a subset of patients can benefit from surgical intervention.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hematoma Subdural Agudo
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged80
/
Female
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Humans
/
Male
Idioma:
En
Revista:
Br J Neurosurg
Assunto da revista:
NEUROCIRURGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM