Acquired Brain Injury, Acute Subdural Hematoma
Conditions
Keywords
Acute subdural hematoma, Intracranial hemorrhage, Prognosis, Functional outcome
Brief summary
Acute subdural hematoma (ASDH) is the most common intracranial traumatic lesion that requires surgical intervention. Although there is extensive published research on acute subdural, there remains uncertainty regarding mortality risk and functional outcomes for patients. This study aims to evaluate the effectiveness of contemporary scoring systems in different age groups of ASDH patients to predict functional outcomes.
Detailed description
Acute subdural hematoma (ASDH) is the most common intracranial traumatic lesion that requires surgical intervention. Although there is extensive published research on acute subdural, there remains uncertainty regarding mortality risk and functional outcomes for patients. This study aims to evaluate the effectiveness of contemporary scoring systems in different age groups of ASDH patients to predict functional outcomes. It is our belief that this research will provide valuable insights on the risk of mortality and functional outcomes for ASDH patients. Several clinical and radiologic factors have been identified within the general population that correlate with mortality rates and functional outcomes. There are a number of factors that must be considered in the evaluation of a patient with traumatic brain injury, and a comprehensive assessment is necessary to determine the best course of treatment.
Interventions
PROCEDUREDecompressive craniectomy with evacuation of subdural hematoma
Adult patients who underwent decompressive craniectomy with evacuation of subdural hematoma.
Sponsors
Military University Hospital, Prague
Charles University, Czech Republic
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* surgery due to ASDH * 12 months of follow-up * functional outcome measured by the Glasgow Outcome Scale Extended (GOSE).
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Glasgow Outcome Scale Extended (GOSE) evaluation of global disability and recovery after 12 months. | 12 months follow up | The Glasgow Outcome Scale Extended (GOSE) is an expanded version of the Glasgow Outcome Scale for evaluation of global disability and recovery after traumatic brain injury. It uses eight categories: 1. Death, 2. Vegetative state, 3. Lower severe disability, 4. Upper severe disability, 5. Lower moderate disability, 6. Upper moderate disability - some disability but can potentially return to some form of employment, 7. Lower good recovery - minor physical or mental defect, 8. Upper good recovery - full recovery. A GOSE analysis will be performed on a patient who has undergone evacuation of a subdural hematoma 12 months after the trauma. |
| Trauma severity analyzed using Injury Severity Score (ISS). | once at time of admission | Trauma severity analyzed using Injury Severity Score. The ISS scores ranges from 1 to 75 points (Higher scores correspond to more severe injury and a higher risk of death). |
| Severity of illness analyzed using Acute Physiology and Chronic Health Evaluation II score (APACHE II) | within 24 hours of admission | Severity of patient illness will be analyzed using Acute Physiology and Chronic Health Evaluation II score (APACHE II) which ranges from 0 to 71 points. Higher scores correspond to more severe disease and a higher risk of death. |
| The Glasgow Outcome Scale (GOS) at the time of discharge from the Intensive Care (IC). | through study completion, an average of 1 year | The Glasgow Outcome Score allowing the objective assessment of the patient´s recovery after trauma brain injury. Allows a prediction of the long-term course of rehabilitation to return to work and everyday life. It uses five categories: 1. Death, 2. Persistent vegetative state, 3. Severe disability, 4. Moderate disability, 5. Low disability. |
| The Glasgow Outcome Scale Extended (GOSE) evaluation of global disability and recovery after 6 months. | 6 months follow up | The Glasgow Outcome Scale Extended (GOSE) is an expanded version of the Glasgow Outcome Scale for evaluation of global disability and recovery after traumatic brain injury. It uses eight categories: 1. Death, 2. Vegetative state, 3. Lower severe disability, 4. Upper severe disability, 5. Lower moderate disability, 6. Upper moderate disability - some disability but can potentially return to some form of employment, 7. Lower good recovery - minor physical or mental defect, 8. Upper good recovery - full recovery. A GOSE analysis will be performed on a patient who has undergone evacuation of a subdural hematoma 6 months after the trauma. |
| Level of consciousness at time of injury | through study completion, an average of 1 year | The level of consciousness (using the Glasgow Coma Scale, 3-15 points, higher score means a better outcome) at the time of injury is analyzed. |
| Initial size of subdural hematoma | through study completion, an average of 1 year | Initial size of subdural hematoma measured in millimetres using CT scan. |
| Initial midline shift | through study completion, an average of 1 year | Initial size of midline shift measured in millimetres using CT scan. |
| Chronic use of anti-clotting medication | once at time of admission | The number of patients on chronic anticoagulation therapy will be the subject of analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time from injury to surgery. | 24 hours | The time from the onset of the injury to the evacuation of the subdural hematoma will be analyzed. |
| Time of operation. | up to 4 hours | The operative time of the evacuation of the subdural hematoma will be analyzed. |
| The need for reversal of the effects of anticoagulants. | 24 hours | The number of cases of need for reversal of the effect of chronic anticoagulant medication will be analyzed. |
| Number of revisions. | 24 hours | The number of re-operations that are required within 24 hours of the initial procedure will be analyzed. |
Countries
Czechia
Outcome results
None listed