Identification of prognostic factors in surgically treated patients with acute epidural hematoma

Koki Onodera; Tomoya Kamide; Tatsuki Kimura; Shinya Tabata; Toshiki Ikeda; Yuichiro Kikkawa; Hiroki Kurita

doi:10.4103/ajns.AJNS_129_20

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 532-536
DOI: 10.4103/ajns.AJNS_129_20

Original Article

Identification of prognostic factors in surgically treated patients with acute epidural hematoma

Koki Onodera

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

,

Tomoya Kamide

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

,

Tatsuki Kimura

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

,

Shinya Tabata

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

,

Toshiki Ikeda

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

,

Yuichiro Kikkawa

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

,

Hiroki Kurita

Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama

› Author Affiliations

Abstract

Context: 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. Aim: This study aims to identify the prognostic factors of surgically treated AEDH. Settings and Design: The medical records of 58 consecutive patients with surgically treated AEDH between September 2011 and 2018 were retrospectively reviewed. Subjects and Methods: 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. Statistical Analysis Used: We analyzed prognostic factors in patients with AEDH using univariate and multivariate regression analyses. Results: Univariate and multivariate regression analyses revealed that age (P < 0.01) and the Glasgow Coma Scale (GCS; P < 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. Conclusions: 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.

Key-words:

Acute subdural hematoma - age of onset - Glasgow Coma Scale - prognostic factors - traumatic brain injury

Full Text

References

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