Superiority of craniotomy over supportive care for octogenarians and nonagenarians in operable acute traumatic subdural hematoma
| Autor: | Enyinna L. Nwachuku, Ava M. Puccio, D. Kojo Hamilton, Hansen Deng, James Duehr, David O. Okonkwo, Sebastian Rodriguez-Torres, Kevin P. Patel, Confidence Njoku-Austin |
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| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Traumatic brain injury medicine.medical_treatment Subgroup analysis symbols.namesake Hematoma Hematoma Subdural Acute Humans Medicine Poisson regression Craniotomy Aged Aged 80 and over business.industry Palliative Care General Medicine medicine.disease Surgery Outcome and Process Assessment Health Care Cohort symbols Population study Female Neurology (clinical) Neurosurgery business Follow-Up Studies |
| Zdroj: | Clinical Neurology and Neurosurgery. 212:107069 |
| ISSN: | 0303-8467 |
| DOI: | 10.1016/j.clineuro.2021.107069 |
| Popis: | OBJECTIVE Neurosurgical evacuation in elderly trauma patients is controversial. We analyzed impact of craniotomy for acute subdural hematoma on survival in octogenarians and nonagenarians. Methods The study population included all patients aged ≥ 80 years who presented with acute traumatic SDHs 09/01/15 - 01/01/20, with radiography indicating operative eligibility (i.e. MLS >5 mm and/or overall thickness >10 mm). Of 1054 TBIs aged ≥ 80 years, 104 (9.87%) were surgically indicated. Of these, 35 received craniotomy and 69 received supportive measures due to family/patient wishes or surgeon's professional decision. We analyzed these data using a Poisson regression adjusted for influence of covariates. RESULTS Of 35 craniotomies, 21 (60.00%) were deceased at 2 years of follow-up, compared to 48 (69.57%) deceased of 69 non-surgical patients. No significant demographic differences existed between these groups, other than age (craniotomy patients were younger; median age 84 vs 86; p |
| Databáze: | OpenAIRE |
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