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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 532-536
DOI: 10.4103/ajns.AJNS_129_20
Original Article

Identification of prognostic factors in surgically treated patients with acute epidural hematoma

Koki Onodera
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
,
Tomoya Kamide
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
,
Tatsuki Kimura
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
,
Shinya Tabata
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
,
Toshiki Ikeda
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
,
Yuichiro Kikkawa
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
,
Hiroki Kurita
Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama
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Context: Only few comprehensive studies have investigated acute epidural hematoma (AEDH), and a low incidence of the lesion has been observed in comparison with other types of traumatic brain injuries such as subdural hematoma, traumatic subarachnoid hemorrhage, and contusion. Aim: This study aims to identify the prognostic factors of surgically treated AEDH. Settings and Design: The medical records of 58 consecutive patients with surgically treated AEDH between September 2011 and 2018 were retrospectively reviewed. Subjects and Methods: All patients were diagnosed with AEDHs using 5-mm-slice computed tomography (CT). Information regarding the following demographic and clinical characteristics was collected: age, sex, antithrombotic drug use, mechanisms of injury, time from onset to operation, neurological examination, vital signs, blood examination, and CT findings. Statistical Analysis Used: We analyzed prognostic factors in patients with AEDH using univariate and multivariate regression analyses. Results: Univariate and multivariate regression analyses revealed that age (P < 0.01) and the Glasgow Coma Scale (GCS; P < 0.01) were independent predictive factors for good prognosis. In addition, receiver operating characteristics (ROC) analysis showed that an age of <55 years and a GCS score of >12 were optimal cutoff values for predicting good prognoses, with the areas under the ROC curve of 0.827 and 0.810, respectively. Conclusions: Age and GCS are useful predictors of prognosis in patients with surgically treated AEDH. These findings are appropriate prognostic indicators for urgent surgery performed to treat AEDH and intended to help clinicians make a prompt diagnosis.

Key-words:

Acute subdural hematoma - age of onset - Glasgow Coma Scale - prognostic factors - traumatic brain injury

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 01. April 2020

Angenommen: 19. April 2020

Artikel online veröffentlicht:
16. August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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