Short- and Long-Term Geriatric Mortality After Acute Traumatic Subdural Hemorrhage.

Autor: Benko MJ; Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA. Electronic address: mjbenko@carilionclinic.org., Abdulla SG; Department of Surgery, Harbor - University of California at Los Angeles, Torrance, California, USA., Cuoco JA; Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA., Dhiman N; Department of Radiology, Columbia University, New York, New York, USA., Klein BJ; Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA., Guilliams EL; Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA., Marvin EA; Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA., Howes GA; Division of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech School of Neuroscience, Blacksburg, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA., Collier BR; Division of Trauma Surgery, Carilion Clinic, Roanoke, Virginia, USA., Hamill ME; Division of Trauma Surgery, Carilion Clinic, Roanoke, Virginia, USA.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2019 Oct; Vol. 130, pp. e350-e355. Date of Electronic Publication: 2019 Jun 21.
DOI: 10.1016/j.wneu.2019.06.086
Abstrakt: Background: Acute subdural hemorrhage often occurs in those ≥65 years of age after trauma and tends to yield poor clinical outcomes. Previous studies have demonstrated a propensity toward high in-hospital mortality rates in this population; however, postdischarge mortality data are limited. The objective of the present study was to analyze short- and long-term mortality data after acute traumatic subdural hemorrhage in the geriatric population as well as review the impact of associated clinical variables including mechanism of injury, pre-morbid antithrombotic use, and need for surgical decompression on mortality rates.
Methods: We retrospectively reviewed 455 patients who presented with an isolated traumatic acute subdural hemorrhage to our level-1 trauma center over a 5 year period using our data registry. Patients were then cross-referenced in the National Social Security Death Index for postdischarge mortality rates. United States life tables were used for peer-controlled actuarial comparisons.
Results: Acute traumatic subdural hemorrhage is often a fatal injury in the geriatric population, especially if taking antithrombotics or requiring surgical decompression. Specifically, they have greater in-hospital mortality rates than adults with similar injuries and have significantly lower survival rates for several years following discharge compared with their peer-matched controls.
Conclusions: Here, we found that age is a significant predictor of both short- and long-term survival after acute traumatic subdural hemorrhage. Moreover, the present study corroborates that the need for surgical decompression or the use of pre-morbid antithrombotic medications is associated with increased overall mortality.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: