Emergency and Critical Care Medicine, Saiseikai Shiga Hospital.
Department of Legal Medicine, Shiga University of Medical Science.
Neurol Med Chir (Tokyo). 2020 Aug 15;60(8):402-410. doi: 10.2176/nmc.oa.2020-0030. Epub 2020 Jun 22.
The factors influencing the outcomes of mild/moderate acute subdural hematoma (ASDH) are still unclear. Retrospective analyses were performed to identify such factors. The medical records of all patients who were admitted to Saiseikai Shiga Hospital with mild (Glasgow Coma Scale [GCS] score of 14-15) or moderate (GCS score of 9-13) ASDH between April 2008 and March 2017 were reviewed. Comparisons between the patients who exhibited favorable and poor outcomes were performed. Then, independent factors that contributed to poor outcomes were identified via logistic regression analyses. A total of 266 patients with a mean age of 70.2 were included in this study. The most common concomitant injuries were subarachnoid hemorrhages (SAHs; 56.8%). The patients' Injury Severity Scores (ISS) ranged from 16 to 75 (median: 21). The 66 moderate ASDH patients exhibited significantly higher frequencies of surgery and mortality (24.2% and 13.6%, respectively) than the 200 mild ASDH patients (8.0% and 4.5%, respectively). The factors associated with poor outcomes were age (odds ratio [OR]: 1.06) and the ISS (OR: 1.24) in the mild ASDH patients, and older age (OR: 1.09) and the higher ISS (OR: 1.15) in the moderate group, too.
影响轻度/中度急性硬脑膜下血肿（ASDH）患者预后的因素仍不清楚。本研究通过回顾性分析，旨在确定这些因素。回顾分析 2008 年 4 月至 2017 年 3 月期间在兵库县立医院因轻度（格拉斯哥昏迷量表 [GCS]评分 14-15 分）或中度（GCS 评分 9-13 分）ASDH 入院的所有患者的病历。比较预后良好和不良的患者。然后，通过逻辑回归分析确定导致不良预后的独立因素。共纳入 266 例患者，平均年龄 70.2 岁。最常见的合并损伤是蛛网膜下腔出血（SAH；56.8%）。患者的损伤严重程度评分（ISS）范围为 16-75 分（中位数：21 分）。66 例中度 ASDH 患者的手术和死亡率（分别为 24.2%和 13.6%）明显高于 200 例轻度 ASDH 患者（分别为 8.0%和 4.5%）。轻度 ASDH 患者预后不良的相关因素为年龄（比值比 [OR]：1.06）和 ISS（OR：1.24），而中度 ASDH 患者的相关因素为年龄（OR：1.09）和更高的 ISS（OR：1.15）。
