Atalay Tugay, Ak Hakan, Gülsen Ismail, Karacabey Sinan
Gaziantep Sevgi Hospital Neurosurgery Department, Gaziantep, Turkey.
Department of Neurosurgery, School of Medicine, Bozok University, Yozgat, Turkey.
J Res Med Sci. 2019 Mar 25;24:27. doi: 10.4103/jrms.JRMS_14_16. eCollection 2019.
Acute subdural hematoma (ASDH) is mostly seen after head injury and is a major cause of morbidity and mortality. We studied the risk factors for ASDH and the effects of these factors on mortality as well as on survival with 100 cases from the rural area of Anatolia region.
One-hundred cases of the ASDH that had been treated surgically between 2011 and 2014, at three different health-care centers from the rural area of Anatolia region, were retrospectively reviewed. Demographic data of patients, etiology, Glasgow Coma Scale (GCS) on admission, survival, presence of comorbid disease, unilaterality or bilaterality of the hematoma, and length of stay in the Intensive Care Unit (ICU) and/or neurosurgery clinic were recorded from the patients' files.
The total mortality rate was 34%. Age, etiology, GCS on admission, and laterality of the hematoma (unilateral or bilateral) affected the mortality rates ( = 0.005, = 0.001, = 0.001, and = 0.001, respectively). Advanced age, low GCS on admission, and bilaterality of the hematoma were related with high mortality rates ( = 0.005, = 0.001, and = 0.001, respectively). The presence of comorbid disease and gender had no effect on patient survival ( = 0.299 and = 0.861).
The most important factors affecting the mortality rate were GCS on admission, etiology, age, and laterality of the hematoma in this study. Advanced age, low GCS on admission, and bilaterality of the hematoma were related with high mortality rates. Etiology had an important role in mortality rates, especially in the pedestrian injury group.
急性硬膜下血肿(ASDH)多见于头部受伤后,是发病和死亡的主要原因。我们以安纳托利亚地区农村的100例病例研究了ASDH的危险因素以及这些因素对死亡率和生存情况的影响。
回顾性分析2011年至2014年期间在安纳托利亚地区农村三个不同医疗中心接受手术治疗的100例ASDH病例。从患者病历中记录患者的人口统计学数据、病因、入院时的格拉斯哥昏迷量表(GCS)评分、生存情况、合并症的存在情况、血肿的单侧或双侧情况以及在重症监护病房(ICU)和/或神经外科诊所的住院时间。
总死亡率为34%。年龄、病因、入院时的GCS评分以及血肿的侧别(单侧或双侧)影响死亡率(分别为P = 0.005、P = 0.001、P = 0.001和P = 0.001)。高龄、入院时GCS评分低以及血肿双侧性与高死亡率相关(分别为P = 0.005、P = 0.001和P = 0.001)。合并症的存在和性别对患者生存无影响(P = 0.299和P = 0.861)。
本研究中影响死亡率的最重要因素是入院时的GCS评分、病因、年龄和血肿侧别。高龄、入院时GCS评分低以及血肿双侧性与高死亡率相关。病因在死亡率中起重要作用,尤其是在行人受伤组。