Abstract
Introduction Antithrombotic medication has proven efficacy in the treatment and prevention of
cardiovascular and cerebrovascular diseases. A major disadvantage is the increased
incidence of cerebral hemorrhages such as subdural hematomas (SDH). The impact of
antithrombotic therapy on the outcome of subdural hematoma is not well characterized
to date.
Materials and Methods We retrospectively analyzed patients with subdural hematomas admitted to our hospital
between 2005 and 2009. Antithrombotic medication, as well as other risk factors (age,
sex, and preexisting diseases) were statistically analyzed in 476 consecutive patients
for an independent association with inferior outcome, such as recurrent hematoma or
in-hospital death. The patients had been evaluated and treated according to clinical
standards for the management of severe head injury and were divided into groups with
chronic SDH (cSDH) and acute SDH (aSDH), respectively.
Results Of 312 patients with aSDH, 71 (22.8%) patients had at least one recurrence and 41
(13.1%) patients died in hospital. In the aSDH group, both the recurrence and the
mortality were associated with anticoagulant therapy and with platelet aggregation
inhibition. In the group of 163 patients with cSDH, 40 (24.5%) patients had a recurrence
and 13 (7.9%) patients died within 9 weeks. Neither the application of platelet aggregation
inhibitors nor the anticoagulant therapy were associated with recurrence or in-hospital
mortality in this group.
Conclusion Our results clearly indicate that prehospital antithrombotic therapy was independently
associated with inferior outcome of patients with aSDH, while no association for patients
with cSDH was observed.
Keywords
antithrombotic medication - subdural hematoma - outcome
