Frequency and Determinants of Surgical Intervention in Traumatic Epidural Hematoma Cases: A Retrospective Study

Abstract

Objective:  To determine the frequency of surgical intervention among patients with traumatic extradural hematoma (EDH) and identify clinical and radiological factors associated with the decision to operate.

Materials and Methods:  A retrospective review of 141 patients diagnosed with traumatic EDH was conducted at a tertiary care neurosurgical center. Demographic, clinical, and radiological variables, including age, sex, Glasgow Coma Scale (GCS) at presentation, EDH volume, maximal thickness, midline shift (MLS), skull fracture, and the frequency of surgical intervention, were recorded. The chi-square test was used to assess associations, and independent predictors of surgery were identified using binary logistic regression. A p-value <0.05 was considered statistically significant.

Conclusion:  Surgical evacuation of extradural hematoma (EDH) is required in nearly one-third of patients. Hematoma volume and thickness, together with neurological status at presentation, were the strongest predictors of operative management, which shows the importance of objective radiological parameters in surgical decision-making.