gms | German Medical Science

Objective: Acute subdural hemorrhage (aSDH) is often associated with bad outcome after traumatic brian injury. Since society is coninuously aging, we were interested to find out if age > 65 years is a significant factor for bad outcome or if other factors in this aging society are influencing outcome.

Methods: We retrospectively analyzed data of patients with the ICD code S06.5 from the last 11 years. Ct scans and charts were checked for aSDH, age, mass lesion, midline shift, coagulopathy or intake of anticoagulants, GOS at discharge and GCS on admission.

Results: So far we analyzed 130 data sets. 60 patients had to be excluded due to wrong use of code S06.5, missing data or missing ct scans. Mean age was 66 years with a median of 70 years. 37 patients were in the group of 65 and older, 33 were younger. Median outcome in the former group was 3 comparde to 4 in the latter. In the group > 65 years 26 patients were in the GOS group 1-3 (p=0.074), 16 of those had an additional coagulopathy. In addtion 16 older patients had a midline shift > 10 mm, 15 of which had bad outcome.

Conclusion: From our data so far we conclude that patients older than 65 years are at high risk for adverse outcome, especially if they are on anticoagulants or have another form of coagulopathy. If in addition to age > 65 years a midline shift of more than 10 mm is present at time of admission the risk for adverse outcome is significantly increased compared to patients < 65 years independent if surgery is performed or not.