| Autor: |
Vazquez S; School of Medicine, New York Medical College, Valhalla, NY 10595, USA., Jain AK; School of Medicine, New York Medical College, Valhalla, NY 10595, USA., Nolan B; School of Medicine, New York Medical College, Valhalla, NY 10595, USA.; Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA., Spirollari E; School of Medicine, New York Medical College, Valhalla, NY 10595, USA., Clare K; School of Medicine, New York Medical College, Valhalla, NY 10595, USA.; Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA., Thomas A; Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA., Soldozy S; Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA., Ali S; Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA., Sukul V; Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA., Rosenberg J; Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA., Mayer S; Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA., Khatri R; Department of Neurology, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX 79409, USA., Jankowitz BT; Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA., Singer J; Department of Neurological Surgery, Spectrum Health, Grand Rapids, MI 49503, USA., Gandhi C; School of Medicine, New York Medical College, Valhalla, NY 10595, USA.; Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA., Al-Mufti F; School of Medicine, New York Medical College, Valhalla, NY 10595, USA.; Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA. |
| Abstrakt: |
As the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score. Of 29,915 patients admitted with moderate-to-severe subdural hematomas, 12,135 (40.6%) died within the same hospital admission. In a multivariate model of relevant demographic and clinical covariates, age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were independent predictors of mortality ( p < 0.001 for all). Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were assigned a "1" in a weighted mortality score. The ROC curve for our model showed an area under the curve of 0.64. Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were predictive of mortality. We created the first clinically relevant weighted mortality score that can be used to stratify risk, guide prognosis, and inform family discussions. |
