Acute traumatic subdural hematoma: current mortality and functional outcomes in adult patients at a Level I trauma center

J Trauma Acute Care Surg. 2012 Nov;73(5):1348-54. doi: 10.1097/TA.0b013e31826fcb30.


Background: Existing data on outcomes following subdural hematoma have provided limited information on medical complications and functional outcomes. Mortality rates previously reported range from 22% to 66%.

Methods: This is a retrospective cohort study of prospectively collected data from a trauma registry in Washington State from 2005 through 2008. Patients were categorized by surgical evacuation status with the hypothesis that those undergoing evacuation represented a more severe injury.

Results: The 1,427 patients included in the study had a mean age of 58 years, and most of them were male (63%). Glasgow Coma Scale (GCS) score on presentation was greater than 12 in 58%; the average Injury Severity Score (ISS) was 27.5. Mean length of stay was 9.6 days (range, 1-110), with 40% spending 2 or more days in the intensive care unit. Twenty-eight percent experienced medical complications. At discharge, 94% had GCS score of 13 or greater. Independence with expression, feeding, and locomotion at discharge was noted for 92%, 81%, and 43%, respectively. Inpatient mortality was 16% and did not differ significantly between the evacuated group (15%) and the nonevacuated group (17%).

Conclusion: This large cohort of patients with acute traumatic subdural hematoma demonstrated a lower mortality rate than those of previous reports, including among patients requiring surgical evacuation (J Trauma Acute Care Surg. 2012;73:1348-1352).

Level of evidence: Epidemiologic study, level III.

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hematoma, Subdural / complications
  • Hematoma, Subdural / mortality*
  • Hematoma, Subdural / therapy*
  • Hospital Mortality
  • Hospitalization*
  • Humans
  • Male
  • Middle Aged
  • Recovery of Function
  • Retrospective Studies
  • Trauma Centers*
  • Trauma Severity Indices
  • Treatment Outcome
  • Washington
  • Young Adult