gms | German Medical Science

Objective: The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population.

Method: From January 1, 2004 to December 31, 2014, 318 consecutive surgically treated traumatic acute subdural hematoma patients were registered. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality.

Results: We observed a negative correlation between 30-day mortality and Glasgow Coma Scale score (per 1-point score increase) (hazard ratio, 0.60; 95% confidence interval, 0.52 to 0.70; P<0.001). In addition, use of antithrombotic (hazard ratio, 2.34; 95% confidence interval, 1.27 to 4.33; P=0.008), history of diabetes mellitus (hazard ratio, 2.28; 95% confidence interval, 1.20 to 4.32; P=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% confidence interval, 1.27 to 3.58; P=0.005) were positively associated with 30-day mortality.

Conclusions: We found a significant association between short-term mortality and lower Glasgow Coma Scale score, use of antithrombotic, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage after surgery for traumatic acute subdural hematoma. We expect these findings to be helpful for selecting patients and predicting prognosis for surgically treated traumatic acute subdural hematoma patients.