Factors influencing hematoma expansion in delayed brain CT scans of patients with traumatic Epidural Hematoma.

Abstract

Epidural hematoma (EDH) is a type of intracranial hematoma commonly observed in trauma patients. This research aims to evaluate the factors contributing to the expansion of traumatic epidural hematoma (EDH). This retrospective cohort study examined traumatic patients with EDH admitted to Taleqani Hospital, a prominent Western Trauma Center in Iran, from 2018 to 2023. Patients underwent an initial CT scan, and non-surgical patients received a delayed CT scan approximately 5 hours after the initial scan. Data analysis was performed using SPSS version 25 software. The study included 274 brain trauma patients with epidural hematoma. Among these patients, 142 (51.8%) did not undergo surgery, and 121 (85.2%) of the non-surgical patients were male. Motor vehicle accidents (MVAs) were the primary cause of EDH in 127 (46.4%) patients. The mean (±standard deviation) initial hematoma size was 8.86 (±9.71), and the mean (±standard deviation) delayed CT scan size was 8.12 (±8.10). In crude linear regression Two variables, namely Hematoma volume in the initial CT scan (P less than 0.001) and Mixed Density (P=0.007), were found to significantly impact the increase in hematoma size in delayed CT scans of non-surgical patients. But in the adjusted linear regression model, only the Hematoma volume in primary CT scan, was significant (P less 0.001). The R Square values were 0.72. The identification of key variables influencing hematoma volume in delayed CT scans has the potential to guide more effective interventions, thereby improving patient outcomes and reducing trauma-related mortality.