Michael J Benko1, Sarah G Abdulla2, Joshua A Cuoco3, Nitasha Dhiman4, Brendan J Klein3, Evin L Guilliams3, Eric A Marvin3, Gregory A Howes3, Bryan R Collier5, Mark E Hamill5. 1. Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA. Electronic address: mjbenko@carilionclinic.org. 2. Department of Surgery, Harbor - University of California at Los Angeles, Torrance, California, USA. 3. Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA. 4. Department of Radiology, Columbia University, New York, New York, USA. 5. Division of Trauma Surgery, Carilion Clinic, Roanoke, Virginia, USA.
Abstract
BACKGROUND: Acute subdural hemorrhage often occurs in those ≥65 years of age after trauma and tends to yield poor clinical outcomes. Previous studies have demonstrated a propensity toward high in-hospital mortality rates in this population; however, postdischarge mortality data are limited. The objective of the present study was to analyze short- and long-term mortality data after acute traumatic subdural hemorrhage in the geriatric population as well as review the impact of associated clinical variables including mechanism of injury, pre-morbid antithrombotic use, and need for surgical decompression on mortality rates. METHODS: We retrospectively reviewed 455 patients who presented with an isolated traumatic acute subdural hemorrhage to our level-1 trauma center over a 5 year period using our data registry. Patients were then cross-referenced in the National Social Security Death Index for postdischarge mortality rates. United States life tables were used for peer-controlled actuarial comparisons. RESULTS: Acute traumatic subdural hemorrhage is often a fatal injury in the geriatric population, especially if taking antithrombotics or requiring surgical decompression. Specifically, they have greater in-hospital mortality rates than adults with similar injuries and have significantly lower survival rates for several years following discharge compared with their peer-matched controls. CONCLUSIONS: Here, we found that age is a significant predictor of both short- and long-term survival after acute traumatic subdural hemorrhage. Moreover, the present study corroborates that the need for surgical decompression or the use of pre-morbid antithrombotic medications is associated with increased overall mortality.
BACKGROUND: Acute subdural hemorrhage often occurs in those ≥65 years of age after trauma and tends to yield poor clinical outcomes. Previous studies have demonstrated a propensity toward high in-hospital mortality rates in this population; however, postdischarge mortality data are limited. The objective of the present study was to analyze short- and long-term mortality data after acute traumatic subdural hemorrhage in the geriatric population as well as review the impact of associated clinical variables including mechanism of injury, pre-morbid antithrombotic use, and need for surgical decompression on mortality rates. METHODS: We retrospectively reviewed 455 patients who presented with an isolated traumatic acute subdural hemorrhage to our level-1 trauma center over a 5 year period using our data registry. Patients were then cross-referenced in the National Social Security Death Index for postdischarge mortality rates. United States life tables were used for peer-controlled actuarial comparisons. RESULTS: Acute traumatic subdural hemorrhage is often a fatal injury in the geriatric population, especially if taking antithrombotics or requiring surgical decompression. Specifically, they have greater in-hospital mortality rates than adults with similar injuries and have significantly lower survival rates for several years following discharge compared with their peer-matched controls. CONCLUSIONS: Here, we found that age is a significant predictor of both short- and long-term survival after acute traumatic subdural hemorrhage. Moreover, the present study corroborates that the need for surgical decompression or the use of pre-morbid antithrombotic medications is associated with increased overall mortality.
Authors: Irfaan A Dar; Imad R Khan; Ross K Maddox; Olga Selioutski; Kelly L Donohue; Mark A Marinescu; Sunil M Prasad; Nadim H Quazi; Jack S Donlon; Emily A Loose; Gabriel A Ramirez; Jingxuan Ren; Joseph B Majeski; Kenneth Abramson; Turgut Durduran; David R Busch; Regine Choe Journal: Biomed Opt Express Date: 2020-10-19 Impact factor: 3.732
Authors: Jorge F Urquiaga; Mayur S Patel; Najib El Tecle; Nabiha Quadri; Georgios Alexopoulos; Richard D Bucholz; Philippe J Mercier; Joanna M Kemp; Jeroen Coppens Journal: Cureus Date: 2022-08-01