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| Name | Class |
|---|---|
| Military University Hospital, Prague | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Surgery Group | Adult patients who underwent surgery due to acute subdural hematoma |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Decompressive craniectomy with evacuation of subdural hematoma | Procedure | Adult patients who underwent decompressive craniectomy with evacuation of subdural hematoma. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Level of consciousness at time of injury | 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. | through study completion, an average of 1 year |
| Initial size of subdural hematoma | Initial size of subdural hematoma measured in millimetres using CT scan. | through study completion, an average of 1 year |
| Initial midline shift | Initial size of midline shift measured in millimetres using CT scan. | through study completion, an average of 1 year |
| Chronic use of anti-clotting medication | The number of patients on chronic anticoagulation therapy will be the subject of analysis. | once at time of admission |
| Trauma severity analyzed using Injury Severity Score (ISS). | 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). | once at time of admission |
| Severity of illness analyzed using Acute Physiology and Chronic Health Evaluation II score (APACHE II) | 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. | within 24 hours of admission |
| The Glasgow Outcome Scale (GOS) at the time of discharge from the Intensive Care (IC). |
| Measure | Description | Time Frame |
|---|---|---|
| Number of revisions. | The number of re-operations that are required within 24 hours of the initial procedure will be analyzed. | 24 hours |
| Time from injury to surgery. | The time from the onset of the injury to the evacuation of the subdural hematoma will be analyzed. |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients who underwent surgery due to acute subdural hematoma in a single institution.
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| Name | Affiliation | Role |
|---|---|---|
| Tomáš Tyll, M.D., Ph.D. | Charles University, Czech Republic | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Military University Hospital Prague | Prague | 16209 | Czechia |
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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. |
| through study completion, an average of 1 year |
| The Glasgow Outcome Scale Extended (GOSE) evaluation of global disability and recovery after 6 months. | 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. | 6 months follow up |
| The Glasgow Outcome Scale Extended (GOSE) evaluation of global disability and recovery after 12 months. | 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. | 12 months follow up |
| 24 hours |
| Time of operation. | The operative time of the evacuation of the subdural hematoma will be analyzed. | up to 4 hours |
| The need for reversal of the effects of anticoagulants. | The number of cases of need for reversal of the effect of chronic anticoagulant medication will be analyzed. | 24 hours |
| ID | Term |
|---|---|
| D020199 | Hematoma, Subdural, Acute |
| D001930 | Brain Injuries |
| D020300 | Intracranial Hemorrhages |
| ID | Term |
|---|---|
| D006408 | Hematoma, Subdural |
| D020198 | Intracranial Hemorrhage, Traumatic |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006406 | Hematoma |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| D056424 | Decompressive Craniectomy |
| ID | Term |
|---|---|
| D019299 | Decompression, Surgical |
| D013514 | Surgical Procedures, Operative |
| D003399 | Craniotomy |
| D019635 | Neurosurgical Procedures |
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