Factors Predicting Outcome of Surgically Treated Acute Subdural Hematoma
DOI:
https://doi.org/10.36552/pjns.v27i3.908Keywords:
acute subdural hematoma, operative mortality, prognostic factors, GCS: Glasgow coma scale, Glasgow outcome scale (GOS).Abstract
Objective: The study aimed to evaluate operative mortality and prognosis factors in posttraumatic acute subdural hematoma patients.
Material & Methods: A prospective cross-sectional study was done in the Department of Neurosurgery, Ayub Teaching Hospital Abbottabad. 82 patients operated for Acute Subdural Hematoma were included in the study. Variables that influence the outcome were recorded. The outcome was measured in terms of mortality.
Results: Of 82 patients operated on, 61 were male, and 21 were female. 51 were <40 old years, 21 were aged 41-60, and 7 were over 60. The most common cause is fall from height (47.6%). Cerebral contusion is often associated (28%). Overall mortality: 39.2%. Male mortality: 29.2%, female: 9.7%. Surgery >4 hours post-injury had higher mortality (18.2%) vs. <4 hours (8.5%). 14/43 GCS <8 patients survived, with no deaths when GCS >12. Pupillary abnormalities had higher mortality (31.9%) vs. normal pupils (7.3%). No deaths with hematoma thickness <10mm and only 1 survived with a thickness >16mm. 25/29 died with midline shift >11mm.
Conclusion: Prognostic factors for surgically treated traumatic acute subdural hematoma include GCS at presentation, pupils, hematoma thickness, midline shift, and time to surgery. Better outcomes associated with GCS>9, normal pupils, hematoma width <1.5cm, midline shift <1cm, and surgery within 4 hours.
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