急性硬膜下血腫の転帰不良因子の検討および転帰予測

抄録

We statistically investigated the factors associated with a poor outcome of acute subdural hematoma from among the level of consciousness at presentation, vital signs, neurological findings, and CT findings. The effect of surgery on the outcome was also assessed. [Subjects and Methods] The study was performed in 333 patients with acute subdural hematoma. Logistic regression analysis was used to identify factors that were associated with a poor outcome. Also, the outcome was compared according to the presence or absence of surgery using Kaplan-Meier survival analysis. A good outcome was defined as "good recovery" or "moderate disability" according to the Glasgow Outcome Scale assessment at 6 months after injury, while a poor outcome was defined as "severe disability", "persistent vegetative state", or "death". [Results] A midline shift of greater than 20 mm, absence of the basal subarachnoid space, the presence of left temporal lesions, and the presence of pupillary abnormalities at presentation were found to be indicators of a poor outcome. Surgery was suggested to improve the outcome for 10% of acute subdural hematoma patients generally believed to have a poor prognosis.