Abstract
Traumatic subarachnoid hemorrhage (SAH) is the second most frequent intracranial hemorrhage and a common radiologic finding in computed tomography. This study aimed to estimate the risk of mortality in adult trauma patients with traumatic SAH concurrent with other types of intracranial hemorrhage, such as subdural hematoma (SDH), epidural hematoma (EDH), and intracerebral hemorrhage (ICH), compared to the risk in patients with isolated traumatic SAH. We searched our hospital’s trauma database from 1 January, 2009 to 31 December, 2018 to identify hospitalized adult patients ≥20 years old who presented with a trauma abbreviated injury scale (AIS) of ≥3 in the head region. Polytrauma patients with an AIS of ≥3 in any other region of the body were excluded. A total of 1856 patients who had SAH were allocated into four exclusive groups: (Group I) isolated traumatic SAH, n = 788; (Group II) SAH and one diagnosis, n = 509; (Group III) SAH and two diagnoses, n = 493; and (Group IV) SAH and three diagnoses, n = 66. One, two, and three diagnoses indicated occurrences of one, two, or three other types of intracranial hemorrhage (SDH, EDH, or ICH). The adjusted odds ratio with a 95% confidence interval (CI) of the level of mortality was calculated with logistic regression, controlling for sex, age, and pre-existing comorbidities. Patients with isolated traumatic SAH had a lower rate of mortality (1.8%) compared to the other three groups (Group II: 7.9%, Group III: 12.4%, and Group IV: 27.3%, all p < 0.001). When controlling for sex, age, and pre-existing comorbidities, we found that Group II, Group III, and Group IV patients had a 4.0 (95% CI 2.4–6.5), 8.9 (95% CI 4.8–16.5), and 21.1 (95% CI 9.4–47.7) times higher adjusted odds ratio for mortality, respectively, than the patients with isolated traumatic SAH. In this study, we demonstrated that compared to patients with isolated traumatic SAH, traumatic SAH patients with concurrent types of intracranial hemorrhage have a higher adjusted odds ratio for mortality.
Highlights
Traumatic brain injury (TBI) is a leading cause of death in trauma patients
The outcome is good for patients with isolated traumatic subarachnoid hemorrhage (SAH), which is defined as the exclusive presence of SAH without any other traumatic, radiographic intracranial pathology in the trauma patient
By controlling for baseline differences in patient characteristics such as sex, age, and pre-existing comorbidities, this study aimed to estimate the risk of mortality in adult trauma patients with traumatic SAH and concurrent intracranial hemorrhages compared to the risk in patients with isolated traumatic SAH
Summary
Traumatic brain injury (TBI) is a leading cause of death in trauma patients. In patients with TBI, the traumatic subarachnoid hemorrhage (SAH) is the second-most frequent intracranial hemorrhage [1] and a common radiologic finding on computed tomography (CT) [2]. It is estimated that in patients with moderate or severe TBI, 33–60% have traumatic SAH [3,4,5,6]. The actual death rate and the requirement for neurosurgical intervention in SAH cases is significantly lower than in cases of non-SAH intracranial hemorrhages [8]. The outcome is good for patients with isolated traumatic SAH, which is defined as the exclusive presence of SAH without any other traumatic, radiographic intracranial pathology in the trauma patient.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Environmental Research and Public Health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
