Abstract
Background: Craniotomy and decompressive craniectomy and are surgical modalities for the evacuation of acute subdural hematoma (SDH). These two techniques show different outcomes in various existing studies. The superiority between either techniques remains controversial. Objective: To determine the outcome comparison of mortality and Glasgow Outcome Scale Extended (GOSE) craniotomy with decompressive craniectomy in patients with traumatic acute SDH. Methods: This is a historical cohort study. Samples of the study were collected from January 2018 to March 2020 at Sanglah General Hospital. All patients with acute traumatic SDH who underwent SDH evacuation with craniotomy and decompressive craniectomy were assessed for mortality status at discharge and GOSE 3 months after surgery. Independent T-test will be carried out if the numerical variable were all normally distributed, while Mann-Whitney U test will be performed if otherwise. A Chi-square test will be performed on all unpaired categorical variables. Statistical analysis was performed with SPSS 25 with 95% confidence intervals. Results: As many as 40 subjects with traumatic acute SDH who underwent craniotomy and 40 subjects with traumatic acute SDH who underwent decompressive craniectomy were included in this study. There was no significant difference in mortality (RR: 1; 95% CI 0.67-1.87; p=0.651) and GOSE score (p=0.718) in traumatic acute SDH who underwent craniotomy or decompressive craniectomy. Conclusion: There was no difference in mortality and GOSE outcomes between a craniotomy and decompressive craniectomy for management of traumatic acute SDH.
Highlights
Craniotomy and decompressive craniectomy and are surgical modalities for the evacuation of acute subdural hematoma (SDH)
The objectives of this study are determine the characteristics of the sample and to compare the Glasgow Outcome Scale bivariate analysis to compare mortality and Extended (GOSE) and mortality outcomes of Glasgow Outcome Scale Extended (GOSE) scores between the two groups craniotomy and decompressive craniectomy
Other variables to be assessed are conducted at the Sanglah General Hospital, age, sex, Glasgow Coma Scale (GCS) score, pupil size, SDH thickness
Summary
Acute subdural hematoma (SDH) is a major and the duramater.[2]. Managements of problem in traumatic head injury.[1]. Outcomes assessed evacuation of traumatic acute SDH.[4] from this research are mortality and Glasgow. Complications.[6] Decompressive GOS Extended (GOSE) is an outcome craniectomy has efficacy in saving patients’ measurement scale of the head injury that is life, it is accompanied by a myriad used to state the prognosis. The most common categories (Table 1).[8] complications are bleeding, infection or The data that has been collected will be inflammation, and disruption of the CSF processed in 2 stages, namely descriptively to compartment.[7] The objectives of this study are determine the characteristics of the sample and to compare the Glasgow Outcome Scale bivariate analysis to compare mortality and Extended (GOSE) and mortality outcomes of GOSE scores between the two groups craniotomy and decompressive craniectomy (craniotomy and decompressive craniectomy). The variables to be assessed are the type of surgery as the independent variable, mortality
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