The epidemiology of surgically treated acute subdural and epidural hematomas in patients with head injuries: a population-based study

Background The purpose of this paper is to review the population-based epidemiology of surgically treated post-traumatic epidural hematomas (EDHs) and/or subdural hematomas (SDHs) among patients who presented to the single neurosurgical centre in Nova Scotia. Methods We included all patients aged 16...

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Vydané v:Canadian Journal of Surgery Ročník 51; číslo 5; s. 339 - 345
Hlavní autori: Tallon, John M., MD, Ackroyd-Stolarz, Stacy, PhD, Karim, Saleema A., MHSA, MBA, Clarke, David B., MDCM, PhD
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Canada CMA Impact Inc 01.10.2008
CMA Impact, Inc
Canadian Medical Association
Predmet:
Accidental Falls - statistics & numerical data
Accidents, Traffic - statistics & numerical data
Adolescent
Adult
Air Ambulances - statistics & numerical data
Care and treatment
Complications and side effects
Decompression, Surgical
Diagnosis
Epidemiology
Epidural hematoma
Female
Glasgow Outcome Scale
Head injuries
Head Injuries, Closed - complications
Hematoma, Epidural, Cranial - epidemiology
Hematoma, Epidural, Cranial - etiology
Hematoma, Epidural, Cranial - surgery
Hematoma, Subdural, Acute - epidemiology
Hematoma, Subdural, Acute - etiology
Hematoma, Subdural, Acute - surgery
Humans
Male
Middle Aged
Neurosurgery
Nova Scotia - epidemiology
Original
Patient outcomes
Retrospective Studies
Risk factors
Studies
Surgery
Nova Scotia
Canada
Nova Scotia Canada
ISSN:0008-428X, 1488-2310, 1488-2310
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Shrnutí:Background The purpose of this paper is to review the population-based epidemiology of surgically treated post-traumatic epidural hematomas (EDHs) and/or subdural hematomas (SDHs) among patients who presented to the single neurosurgical centre in Nova Scotia. Methods We included all patients aged 16 years or older who presented to the tertiary care hospital with acute post-traumatic EDHs and/or SDHs between May 23, 1996, and May 22, 2005, and who were surgically treated. We generated an initial cohort from the provincial trauma registry and reviewed a total of 152 charts for possible inclusion; 70 (46%) patients met the study criteria. We performed a blinded, explicit chart review using a standardized data collection form, and we generated descriptive statistics. Results Of the patients who had surgery, 34 (49%) presented with SDHs, 23 (33%) presented with EDHs and 13 (19%) presented with both conditions. The median age was 45 years, and 80% of the cohort was male. The major mechanisms of injury were falls (51%), motor vehicle collisions (30%) and assault (11%). More than half (61%) of patients were transferred from referring hospitals while the remainder (39%) arrived directly without an intermediate facility. There were 18 postoperative deaths (26%). Forty-four of 70 patients (63%) had associated good outcomes at 6 months (Glasgow Outcome Scale). Conclusion Acute post-traumatic EDHs and/or SDHs are relatively rare (0.83/100 000 population per annum) and are generally associated with good outcomes. Death was more likely among older, more severely injured patients and among those who required surgery for SDH rather than EDH.
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ISSN:0008-428X
1488-2310
1488-2310
DOI:10.1016/S0008-428X(08)50094-4