Retrospective clinical evaluation of patients undergoing surgery for acute epidural hematoma

We aimed to evaluate mortality-associated factors among patients with acute epidural hematoma due to head trauma. Demographic characteristics, preoperative Glasgow Coma Scale score, epidural hematoma aetiology and radiological findings, accompanying systemic trauma results, hospitalisation duration, sequelae, and mortality features of patients experiencing epidural hematoma between 2014 and 2018 were evaluated. Overall, 79 patients were examined. The most frequent epidural hematoma aetiology was traffic accidents (51.9%), with temporal region being the most common epidural hematoma location (38 [48.2%] patients). Among all, 12 (15.2%) patients died and 67 (84.8%) were discharged. Of them, 57 (85.1%) patients were discharged without and 10 (14.9%) with neurological sequelae. Age>65 years (p=0.001) and low Glasgow Coma Scale score (p<0.05) were significantly associated with higher mortality. Overall mortality rate was 91.7% (p<0.001) in patients with systemic trauma accompanying epidural hematoma, with thoracic (12%) and orthopaedic (9%) trauma being the most common. Cranial injuries included linear fracture, 78.5%; pneumocephalus, 48.1%; cerebral contusion, 44.3%; traumatic subarachnoid haemorrhage, 32.9%; acute subdural hematoma; 26.6%, and collapse fracture, 15%. All cranial injuries except linear fractures were associated with high mortality (p<0.05). Epidural hematoma is associated with high mortality. Aetiology, Glasgow Coma Scale score, cranial pathology, age, and additional trauma are the major predictive mortality-associated factors.