Factors influencing the outcome of patients with acute extradural haematomas undergonig surgery.
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Date
2011
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Abstract
Background: Acute extradural haematoma (EDH) remains most common cause of mortality and
disability resulting from traumatic brain injury. In the last three decades, improvements in rescue,
neuromonitoring, diagnostic procedure and intensive care have led to better outcomes. The
purpose of this study was to evaluate the factors influencing the outcome in patients with EDH
undergoing surgery treated in a tertiary hospital in Bangladesh. Methods: In this retrospective
study, 102 consecutive patients with acute EDH who underwent craniotomy were included. The
study was carried out from July 2003 to December 2005. The diagnosis was made clinically and
radiologically by CT scan. Patients were grouped on the basis of Glasgow Coma Scale (GCS) and
operative outcomes were evaluated by Glasgow Outcome Scale (GOS) Results: More than half
sampled respondents’ (57%) age were more than 20 years while rests of the patients below 20
years with male predominance (Male: Female -12:1). About 7 in 10 respondents (70.6%) were
working. Similarly, majority of the respondents (79.4%) had lost more than 30 ml blood. A notable
proportion of the respondents (73.5%) had good GCS score (9-15 score) during admission.
Similarly majority of the respondents (70.6%) had GCS score 9-15 and 29.4% had GCS score 3-8
before surgery. Road Traffic Accident (RTA) (65%) is the most common cause of EDH followed
by assault (20%) and fall from height (12%). Temporal and temporo-parietal locations were the
most common site of EDH (56%). Patients with good GCS before surgery had significantly better
outcome (89%) compare to those who had bad GCS (10%). Conclusion: Level of consciousness
before surgery is the most important factor affecting the outcome. Hence, early diagnosis and
surgical intervention is very essential.
Description
Keywords
Acute Extradural Haematoma (EDH), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS)
Citation
Islam M J, Saha S K, Elahy M F, Islam K M T, Ahamed S U. Factors influencing the outcome of patients with acute extradural haematomas undergonig surgery. Bangladesh Journal of Medical Science. 2011; 10(2): 112-120.