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

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...

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Bibliographic Details
Published in:	World neurosurgery Vol. 130; pp. e350 - e355
Main Authors:	Benko, Michael J, Abdulla, Sarah G, Cuoco, Joshua A, Dhiman, Nitasha, Klein, Brendan J, Guilliams, Evin L, Marvin, Eric A, Howes, Gregory A, Collier, Bryan R, Hamill, Mark E
Format:	Journal Article
Language:	English
Published:	United States 01-10-2019
Subjects:	Adolescent Adult Age Factors Aged Aged, 80 and over Female Hematoma, Subdural, Acute - mortality Hospital Mortality Humans Kaplan-Meier Estimate Male Middle Aged Retrospective Studies Subarachnoid Hemorrhage, Traumatic - mortality Young Adult Traumatic brain injury Closed head injury Geriatric Subdural hemorrhage Elderly Trauma Subdural hematoma
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Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1878-8750 1878-8769
DOI:	10.1016/j.wneu.2019.06.086