Outcome after acute traumatic subdural and epidural haematoma in Switzerland: a single-centre experience

Taussky, Philipp; Widmer, Hans Rudolf; Takala, Jukka; Fandino, Javier (2008). Outcome after acute traumatic subdural and epidural haematoma in Switzerland: a single-centre experience. Swiss medical weekly, 138(19-20), pp. 281-5. Muttenz: EMH Schweizerischer Ärzteverlag

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BACKGROUND: Acute epidural and subdural haematomas remain among the most common causes of mortality and disability resulting from traumatic brain injury. In the last three decades improvements in rescue, neuromonitoring and intensive care have led to better outcomes. The purpose of this study was to evaluate the impact of these strategies on outcome in patients treated in a single institution in Switzerland. METHODS: A total of 76 consecutive patients who underwent emergency craniotomy for acute traumatic epidural and subdural haematoma at University Hospital Bern between January 2000 and December 2003 were included in this study. RESULTS: Thirty-seven patients presented with an epidural haematoma and 46 with a subdural haematoma. In seven patients both haematomas could be documented. The median age was 54 years (IQR 28). The median initial GCS score was 7 (IQR 6). The median time from primary injury to surgery was 3 hours (IQR 2.5 hours). The median stay in the ICU was 3 days (IQR: 3 days). The outcome was favourable (GOS 4 and 5) in 43 patients (57%). Thirteen patients (17%) remained severely or moderately disabled (GOS 3). Finally, a total of 21 patients (28%) died or remained in a persistent vegetative state (GOS 1 and 2). Mortality was 41% for acute subdural haematoma (19/46) and 3% (1/37) for patients with epidural haematoma. Only age, GCS at admission and pupil abnormalities seemed to be associated with outcome. Time to surgery was not. CONCLUSION: In patients admitted with acute traumatic epidural and subdural haematomas that are treated within a median of 3 hours after primary injury, factors such as age, initial GCS and pupil abnormalities still appear to be the most important factors correlating with outcome.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Widmer, Hans Rudolf; Takala, Jukka and Fandino, Javier

ISSN:

1424-7860

ISBN:

18491241

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:04

Last Modified:

04 May 2014 23:19

PubMed ID:

18491241

Web of Science ID:

000256200900002

URI:

https://boris.unibe.ch/id/eprint/27655 (FactScience: 109815)

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