Onodera Koki, Kamide Tomoya, Kimura Tatsuki, Tabata Shinya, Ikeda Toshiki, Kikkawa Yuichiro, Kurita Hiroki
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.
Asian J Neurosurg. 2020 Aug 28;15(3):532-536. doi: 10.4103/ajns.AJNS_129_20. eCollection 2020 Jul-Sep.
Only few comprehensive studies have investigated acute epidural hematoma (AEDH), and a low incidence of the lesion has been observed in comparison with other types of traumatic brain injuries such as subdural hematoma, traumatic subarachnoid hemorrhage, and contusion.
This study aims to identify the prognostic factors of surgically treated AEDH.
The medical records of 58 consecutive patients with surgically treated AEDH between September 2011 and 2018 were retrospectively reviewed.
All patients were diagnosed with AEDHs using 5-mm-slice computed tomography (CT). Information regarding the following demographic and clinical characteristics was collected: age, sex, antithrombotic drug use, mechanisms of injury, time from onset to operation, neurological examination, vital signs, blood examination, and CT findings.
We analyzed prognostic factors in patients with AEDH using univariate and multivariate regression analyses.
Univariate and multivariate regression analyses revealed that age ( < 0.01) and the Glasgow Coma Scale (GCS; < 0.01) were independent predictive factors for good prognosis. In addition, receiver operating characteristics (ROC) analysis showed that an age of <55 years and a GCS score of >12 were optimal cutoff values for predicting good prognoses, with the areas under the ROC curve of 0.827 and 0.810, respectively.
Age and GCS are useful predictors of prognosis in patients with surgically treated AEDH. These findings are appropriate prognostic indicators for urgent surgery performed to treat AEDH and intended to help clinicians make a prompt diagnosis.
仅有少数全面的研究对急性硬膜外血肿（AEDH）进行过调查，与其他类型的创伤性脑损伤（如硬膜下血肿、创伤性蛛网膜下腔出血和挫伤）相比，该病变的发生率较低。
本研究旨在确定手术治疗的AEDH的预后因素。
回顾性分析了2011年9月至2018年期间连续58例接受手术治疗的AEDH患者的病历。
所有患者均使用5毫米层厚的计算机断层扫描（CT）诊断为AEDH。收集了以下人口统计学和临床特征信息：年龄、性别、抗血栓药物使用情况、损伤机制、发病至手术的时间、神经学检查、生命体征、血液检查和CT表现。
我们使用单因素和多因素回归分析来分析AEDH患者的预后因素。
单因素和多因素回归分析显示，年龄（<0.01）和格拉斯哥昏迷量表（GCS；<0.01）是良好预后的独立预测因素。此外，受试者工作特征（ROC）分析表明，年龄<55岁和GCS评分>12是预测良好预后的最佳临界值，ROC曲线下面积分别为0.827和0.810。
年龄和GCS是手术治疗的AEDH患者预后的有用预测指标。这些发现是治疗AEDH紧急手术的合适预后指标，旨在帮助临床医生做出快速诊断。
