Clinical Outcome of Patients Diagnosed Traumatic Intracranial Epidural Hematoma With Severe Brain Injuryopen access
- Authors
- Choi, Dae Han; Jeong, Tae Seok; Kim, Woo Kyung
- Issue Date
- Oct-2022
- Publisher
- 대한신경손상학회
- Keywords
- Cranial epidural hematoma; Glasgow Coma Scale; Glasgow Outcome Scale; Traumatic brain injury
- Citation
- Korean Journal of Neurotrauma, v.18, no.2, pp.153 - 160
- Journal Title
- Korean Journal of Neurotrauma
- Volume
- 18
- Number
- 2
- Start Page
- 153
- End Page
- 160
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/86892
- DOI
- 10.13004/kjnt.2022.18.e62
- ISSN
- 2234-8999
- Abstract
- Objective
To evaluate the clinical outcomes and prognostic factors in surgically treated patients with severe brain injury (Glasgow Coma Scale [GCS] score ≤8) diagnosed with traumatic epidural hematoma (EDH).
Methods
From January 2018 to June 2021, 1,122 patients with an initial GCS score ≤8 were retrospectively enrolled in the Korean Neuro-Trauma Data Bank System. Clinical data of 79 surgically treated patients with EDH were compared between the unfavorable (scores of 1–4 on the Glasgow Outcome Scale-Extended [GOSE]) and favorable (score of 5–8 on the GOSE) outcome groups.
Results
The overall mortality rate was 13.9%, and 60.8% of the patients had good outcomes at six months post-trauma. In the univariate analysis, increasing age (p=0.010), lower initial GCS score (p=0.001), higher Rotterdam computed tomography (CT) score (p=0.012), craniotomy rather than craniectomy (p=0.032), larger EDH volume (p=0.007), and loss of pupillary reactivity (unilateral unreactive pupil, p=0.026; bilateral unreactive pupils, p<0.001), were significantly correlated with unfavorable outcomes. Of these factors, increasing age (p=0.011) and bilateral unreactive pupils (p=0.002) were the most significant risk factors in the multivariate logistic regression analysis. The interval from admission to the brain CT scan was not correlated with the outcome; however, it was significantly longer in the unfavorable outcome group.
Conclusion
Despite severe brain injury, more than half of the patients with EDH had favorable outcomes after surgical treatment. Our findings suggest that prompt diagnosis and surgical treatment should be considered for such cases.
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