Mortality in Elderly Patients Operated for an Acute Subdural Hematoma : A Surgical Case Series

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dc.contributor.author Raj, Rahul
dc.contributor.author Mikkonen, Era D.
dc.contributor.author Kivisaari, Riku
dc.contributor.author Skrifvars, Markus B.
dc.contributor.author Korja, Miikka
dc.contributor.author Siironen, Jari
dc.date.accessioned 2017-09-14T09:53:51Z
dc.date.available 2021-12-17T18:45:27Z
dc.date.issued 2016-04
dc.identifier.citation Raj , R , Mikkonen , E D , Kivisaari , R , Skrifvars , M B , Korja , M & Siironen , J 2016 , ' Mortality in Elderly Patients Operated for an Acute Subdural Hematoma : A Surgical Case Series ' , World Neurosurgery , vol. 88 , pp. 592-597 . https://doi.org/10.1016/j.wneu.2015.10.095
dc.identifier.other PURE: 64476972
dc.identifier.other PURE UUID: 2e7e07b0-e061-48bf-961d-565b9655a15f
dc.identifier.other WOS: 000374649700077
dc.identifier.other Scopus: 84953432359
dc.identifier.other ORCID: /0000-0002-4463-6954/work/58742452
dc.identifier.uri http://hdl.handle.net/10138/223996
dc.description.abstract BACKGROUND: Surgery for elderly patients with acute subdural hematomas (ASDH) is controversial, because postoperative mortality rates are reported to be high and long-term outcomes unknown. Thus, we aimed to describe midterm and long-term mortality rates of elderly patients operated for an ASDH. METHODS: We reviewed all consecutive >= 75-year-old patients operated on for an ASDH between 2009 and 2012. We recorded data on preadmission functional status (independent or dependent) and use of antithrombotic medication. Patients were followed up a median of 4.2 years (range, 2.5-6.4 years). RESULTS: Forty-four patients were included. The majority of the patients (70%) were independent and taking antithrombotic medication (77%). Independent patients had a 1-year mortality of 42%, compared to 69% for dependent patients; 56% of patients taking antithrombotics and 30% of those without antithrombotics died within the first postoperative year. All patients with an admission Glasgow coma scale score of 3-8 died within the first postoperative year, if they used antithrombotics or were dependent before the injury. Of all 1-year survivors, 77% were alive at the end of follow-up. CONCLUSION: In this first surgical case series of 75-year-old or older patients with ASDH, the overall mortality rate appears to be relatively low, especially for preoperatively conscious and independent patients without antithrombotic medication. Patients alive at 1-year after surgery had a life expectancy comparable to their age-matched peers. The prognosis seems to be detrimental for preoperatively unconscious patients who were functionally dependent or used antithrombotic medication before the injury. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof World Neurosurgery
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Acute subdural hematoma
dc.subject Craniotomy
dc.subject Elderly
dc.subject Mortality
dc.subject Prognosis
dc.subject Prognostic factors
dc.subject Traumatic brain injury
dc.subject TRAUMATIC BRAIN-INJURY
dc.subject HEAD-INJURIES
dc.subject EPIDEMIOLOGY
dc.subject COMA
dc.subject AGE
dc.subject MANAGEMENT
dc.subject IMPACT
dc.subject SCALE
dc.subject 3112 Neurosciences
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Mortality in Elderly Patients Operated for an Acute Subdural Hematoma : A Surgical Case Series en
dc.type Article
dc.contributor.organization Neurokirurgian yksikkö
dc.contributor.organization Clinicum
dc.contributor.organization Department of Neurosciences
dc.contributor.organization Department of Diagnostics and Therapeutics
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.wneu.2015.10.095
dc.relation.issn 1878-8750
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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