Risk factors associated with progression of epidural hematoma after conservative treatment in patients with traumatic brain injury in Suratthani hospital
DOI:
https://doi.org/10.14456/reg11med.2022.13Keywords:
Epidural hematoma, mild traumatic brain injury, Risk factorsAbstract
Background: Epidural hematoma is a common head injury in Thailand. The incidence of progression of epidural hematoma after conservative treatment is higher. Hematoma progression during conservative treatment is associated with high mortality and unexpected neurosurgical intervention. Unfortunately, the rate of progression and associated factors were not well defined, especially in Thailand.
Objective: To evaluate incidence and risk factors of progressive epidural hematoma in Suratthani hospital.
Method: The retrospective descriptive study was performed on 320 patients with epidural hematoma treated in Suratthani hospital between September 2016- and October 2021. Only patients with epidural hematoma treated with initial conservative and received follow-up second CT brain were included in the study.
Results: In this study, they have 320 patients who met the inclusion criteria. The incidence of PEH in this study was 23.1%. Multivariate logistic regression model revealed that decompressive craniectomy on contralateral site (OR= 59.06 95%CI =6.58-530.27 P<0.001), time to first CT brain < 2 hours (OR=3.03 95%CI=1.56-5.90 P=0.001), volume of hematoma on first CT brain ≥10 ml ( OR= 3.82 95% CI =1.89-7.74 P P<0.001) and the heterogeneous density of blood clot on CT brain (OR=3.96 95%CI =1.96-8.01, P < 0.001) were independent risks factors of PEH.
Conclusion: The high incidence of progressive epidural hematoma, especially among patients who have independent risk factors in this study should be received a follow-up second CT brain in 6-24 hours after injury.
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