Neurologic Outcomes for Octogenarians Undergoing Emergent Surgery for Traumatic Acute Subdural Hematoma.

Determining the appropriate surgical indications for obtunded octogenarians with traumatic acute subdural hematoma (aSDH) has been challenging. We sought to determine which easily available data would be useful adjuncts to assist in early and quick decision-making. We performed a single-center, retrospective review of patients aged ≥80 years with confirmed traumatic aSDH who had undergone emergent surgery. The clinical measurements included the Karnofsky performance scale score, Charlson comorbidity index, Glasgow coma scale (GCS), and abbreviated injury score. The radiographic measurements included the Rotterdam computed tomography score, aSDH thickness, midline shift, and optic nerve sheath diameter (ONSD). The neurologic outcomes were defined using the extended Glasgow outcome scale-extended (GOS-E) at hospital discharge and 3-month follow-up. The Pearson correlation coefficient was used to compare the ONSD with all clinical, radiographic, and outcome variables. Multivariate logistic regression was used to assess the relationship between the discharge and 3-month GOS-E scores between all clinical and radiographic variables. A total of 17 patients met the inclusion criteria. The mean age was 82.5 ± 1.6 years (range, 80-85 years), and the mean GCS score was 11.2 ± 4.1 (range, 4-15). The mean discharge and 3-month GOS-E scores were 3.4 ± 2.6 (range, 1-8) and 2.3 ± 2.1 (range, 1-7), respectively. We found significant negative correlations between the ONSD and the GCS score (r = -0.62; P < 0.01) and the ONSD and discharge GOS-E score (r = -0.49; P = 0.05). Multivariate analysis revealed a significant association between the abbreviated injury score and the discharge GOS-E score (P = 0.05). Octogenarians sustaining aSDH and requiring emergent surgery have poor outcomes. More data are needed to determine whether the ONSD can be a useful adjunct tool to predict the efficacy of emergent surgery.

Krueger EM ，Benveniste RJ ，Taylor RR ，Shah S ，Moll J ，Figueroa JM ，Jagid JR ... -  《-》

Acute subdural hematoma in the elderly: outcome analysis in a retrospective multicentric series of 213 patients.

Trevisi G ，Sturiale CL ，Scerrati A ，Rustemi O ，Ricciardi L ，Raneri F ，Tomatis A ，Piazza A ，Auricchio AM ，Stifano V ，Romano C ，De Bonis P ，Mangiola A ... -  《Neurosurgical Focus》

Prognostic significance of hematoma thickness to midline shift ratio in patients with acute intracranial subdural hematoma: a retrospective study.

Moussa WMM ，Khedr WM ，Elwany AH 《-》

Surgical evacuation of acute subdural hematoma in octogenarians: a ten-year experience from a single trauma center.

McGinity MJ ，Michalek JE ，Rodriguez JS ，Floyd JR ... -  《-》

Significant increase in acute subdural hematoma in octo- and nonagenarians: surgical treatment, functional outcome, and predictors in this patient cohort.

Won SY ，Dubinski D ，Brawanski N ，Strzelczyk A ，Seifert V ，Freiman TM ，Konczalla J ... -  《Neurosurgical Focus》