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. 2019 Oct;130:e350-e355.
doi: 10.1016/j.wneu.2019.06.086. Epub 2019 Jun 21.

Short- And Long-Term Geriatric Mortality After Acute Traumatic Subdural Hemorrhage


Short- And Long-Term Geriatric Mortality After Acute Traumatic Subdural Hemorrhage

Michael J Benko et al. World Neurosurg. .


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.

Keywords: Closed head injury; Elderly; Geriatric; Subdural hematoma; Subdural hemorrhage; Trauma; Traumatic brain injury.

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