The Analysis of Surgical Results of Traumatic Acute Subdural Hematoma According to Age

Abstract

Objective: We aimed to analyze the surgical results of traumatic acute subdural hematoma (ASDH) in relation to the age of the patients and to report our recent experiences in treating such patients. Methods: In this retrospective study, we reviewed the case histories of 141 patients with traumatic ASDH, all of whom had undergone surgical evacuation of hematoma in course of a 5-year period. In order to identify the age-dependent clinical characteristics, the patients were divided into 3 groups according to their ages. Group A consisted of 14 patients aged 0-29 years, group B consisted of 54 patients aged 30-59 years, and group C comprised 73 patients aged over 60 years. We analyzed the clinical status, mortality, and outcomes in relation to the ages of the patients. Results: The overall male-to-female ratio was 3.7：1, and the mean age of the patients was 55.7 years (range, 1-85 years); however, the male-to-female ratio in group B was 12.5：1. The most frequent cause of trauma was vehicular accidents. The overall mortality rate was 29%, group A was 21.3%, group B was 14.8%, and group C was 24.7%. There were no significant differences in the mortality among the three groups. However, mortality rate was significantly increased among the patients aged over 70 years and less than 17 years. The surgical outcomes were significantly influenced by the age and the initial Glasgow coma scale (GCS) scores. Conclusion: Our results show the patient’s age was significantly associated with an unfavorable outcome of surgical evacuation of traumatic ASDH. Therefore, we recommend that neurosurgeons should exercise greater caution while considering surgical evacuation in the old-aged group. (J Kor Neurotraumatol Soc 2009;5:5-10)