Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors
Progressive epidural hematoma (PEDH) after head injury is often observed on serial computerized tomography (CT) scans. Recent advances in imaging modalities and treatment might affect its incidence and outcome. In this study, PEDH was observed in 9.2% of 412 head trauma patients in whom two CT scans...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2012/134905 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562786788442112 |
|---|---|
| author | Hao Chen Yan Guo Shi-Wen Chen Gan Wang He-Li Cao Jiong Chen Yi Gu Heng-Li Tian |
| author_facet | Hao Chen Yan Guo Shi-Wen Chen Gan Wang He-Li Cao Jiong Chen Yi Gu Heng-Li Tian |
| author_sort | Hao Chen |
| collection | DOAJ |
| description | Progressive epidural hematoma (PEDH) after head injury is often observed on serial computerized tomography (CT) scans. Recent advances in imaging modalities and treatment might affect its incidence and outcome. In this study, PEDH was observed in 9.2% of 412 head trauma patients in whom two CT scans were obtained within 24 hours of injury, and in a majority of cases, it developed within 3 days after injury. In multivariate logistic regression, patient gender, age, Glasgow Coma Scale (GCS) score at admission, and skull fracture were not associated with PEDH, whereas hypotension (odds ratio (OR) 0.38, 95% confidence interval (CI) 0.17–0.84), time interval of the first CT scanning (OR 0.42, 95% CI 0.19–0.83), coagulopathy (OR 0.36, 95% CI 0.15–0.85), or decompressive craniectomy (DC) (OR 0.46, 95% CI 0.21–0.97) was independently associated with an increased risk of PEDH. The 3-month postinjury outcome was similar in patients with PEDH and patients without PEDH (χ2=0.07, P=0.86). In conclusion, epidural hematoma has a greater tendency to progress early after injury, often in dramatic and rapid fashion. Recognition of this important treatable cause of secondary brain injury and the associated risk factors may help identify the group at risk and tailor management of patients with TBI. |
| format | Article |
| id | doaj-art-11f2ed924bab4292a5ac9f5cb75237b0 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-11f2ed924bab4292a5ac9f5cb75237b02025-02-03T01:21:44ZengWileyEmergency Medicine International2090-28402090-28592012-01-01201210.1155/2012/134905134905Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk FactorsHao Chen0Yan Guo1Shi-Wen Chen2Gan Wang3He-Li Cao4Jiong Chen5Yi Gu6Heng-Li Tian7Department of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaDepartment of Neurosurgery, Shanghai sixth People Hospital, Shanghai Jiaotong University, Shanghai 200233, ChinaProgressive epidural hematoma (PEDH) after head injury is often observed on serial computerized tomography (CT) scans. Recent advances in imaging modalities and treatment might affect its incidence and outcome. In this study, PEDH was observed in 9.2% of 412 head trauma patients in whom two CT scans were obtained within 24 hours of injury, and in a majority of cases, it developed within 3 days after injury. In multivariate logistic regression, patient gender, age, Glasgow Coma Scale (GCS) score at admission, and skull fracture were not associated with PEDH, whereas hypotension (odds ratio (OR) 0.38, 95% confidence interval (CI) 0.17–0.84), time interval of the first CT scanning (OR 0.42, 95% CI 0.19–0.83), coagulopathy (OR 0.36, 95% CI 0.15–0.85), or decompressive craniectomy (DC) (OR 0.46, 95% CI 0.21–0.97) was independently associated with an increased risk of PEDH. The 3-month postinjury outcome was similar in patients with PEDH and patients without PEDH (χ2=0.07, P=0.86). In conclusion, epidural hematoma has a greater tendency to progress early after injury, often in dramatic and rapid fashion. Recognition of this important treatable cause of secondary brain injury and the associated risk factors may help identify the group at risk and tailor management of patients with TBI.http://dx.doi.org/10.1155/2012/134905 |
| spellingShingle | Hao Chen Yan Guo Shi-Wen Chen Gan Wang He-Li Cao Jiong Chen Yi Gu Heng-Li Tian Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors Emergency Medicine International |
| title | Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors |
| title_full | Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors |
| title_fullStr | Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors |
| title_full_unstemmed | Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors |
| title_short | Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors |
| title_sort | progressive epidural hematoma in patients with head trauma incidence outcome and risk factors |
| url | http://dx.doi.org/10.1155/2012/134905 |
| work_keys_str_mv | AT haochen progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT yanguo progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT shiwenchen progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT ganwang progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT helicao progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT jiongchen progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT yigu progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors AT henglitian progressiveepiduralhematomainpatientswithheadtraumaincidenceoutcomeandriskfactors |