The Analysis of Surgical Results of Traumatic Acute Subdural Hematoma According to Age

Hee Sang Koo; Ki Seong Eom; Dae Won Kim; Jong Tae Park; Seong Keun Moon; Sung Don Kang; Tae Young Kim

doi:10.13004/jknts.2009.5.1.5

Journal List > J Korean Neurotraumatol Soc > v.5(1) > 1084048

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Koo, Eom, Kim, Park, Moon, Kang, and Kim: The Analysis of Surgical Results of Traumatic Acute Subdural Hematoma According to Age

Clinical Article

Journal of Korean Neurotraumatology Society 2009; 5(1): 5-10.

Published online: 30 June 2009

DOI: https://doi.org/10.13004/jknts.2009.5.1.5

The Analysis of Surgical Results of Traumatic Acute Subdural Hematoma According to Age

Hee Sang Koo, MD, Ki Seong Eom, MD, Dae Won Kim, MD, Jong Tae Park, MD, Seong Keun Moon, MD, Sung Don Kang, MD, Tae Young Kim, MD

Department of Neurosurgery, Wonkwang University College of Medicine, Iksan, Korea.

Address for correspondence: Ki Seong Eom, MD. Department of Neurosurgery, Wonkwang University College of Medicine, 344-2 Sinyong-dong, Iksan 570-749, Korea. Tel: +82-63-859-1461, Fax: +82-63-852-2606, kseom@wonkwang.ac.kr

Received 10 April 2009 Revised 11 May 2009 Accepted 11 May 2009

Abstract

Objective

We aimed to analyze the surgical results of traumatic acute subdural hematoma (ASDH) in relation to the age of the patients and to report our recent experiences in treating such patients.

Methods

In this retrospective study, we reviewed the case histories of 141 patients with traumatic ASDH, all of whom had undergone surgical evacuation of hematoma in course of a 5-year period. In order to identify the age-dependent clinical characteristics, the patients were divided into 3 groups according to their ages. Group A consisted of 14 patients aged 0-29 years, group B consisted of 54 patients aged 30-59 years, and group C comprised 73 patients aged over 60 years. We analyzed the clinical status, mortality, and outcomes in relation to the ages of the patients.

Results

The overall male-to-female ratio was 3.7:1, and the mean age of the patients was 55.7 years (range, 1-85 years); however, the male-to-female ratio in group B was 12.5:1. The most frequent cause of trauma was vehicular accidents. The overall mortality rate was 29%, group A was 21.3%, group B was 14.8%, and group C was 24.7%. There were no significant differences in the mortality among the three groups. However, mortality rate was significantly increased among the patients aged over 70 years and less than 17 years. The surgical outcomes were significantly influenced by the age and the initial Glasgow coma scale (GCS) scores.

Conclusion

Our results show the patient's age was significantly associated with an unfavorable outcome of surgical evacuation of traumatic ASDH. Therefore, we recommend that neurosurgeons should exercise greater caution while considering surgical evacuation in the old-aged group.

Keywords: Acute subdural hematoma, Age, Surgical treatment, Head trauma

Figures and Tables

FIGURE 1

Age distribution related to mortality.

FIGURE 2

Age related to initial consciousness group.

FIGURE 3

Final outcome in relation to initial consciousness group. GCS: Glasgow outcome scale.

FIGURE 4

Final outcome in relation to age.

TABLE 1

Causes of injury in patients with acute subdural hematoma who underwent surgical evacuation

TABLE 2

Sex ratio in relation to age distribution

TABLE 3

Mortality related to age distribution

TABLE 4

Surgical results in relation to initial consciousness level

^*GCS score 13-15 (n=26), ^†GCS score 9-12 (n=54), ^‡GCS score 3-8 (n=61). GCS: Glasgow coma scale, GOS: Glasgow outcome scale

TABLE 5

Surgical results in relation to age distribution

GOS: Glasgow outcome scale

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