Abstract：
UNASSIGNED: Epidural hematoma is one of the most common surgical emergencies encountered in neurosurgery. This study was conducted to determine the mortality and prognostic factors in patients operated for traumatic intracranial epidural hematoma in a resource-constrained setting from a developing country.
UNASSIGNED: This retrospective study was conducted in the Department of Neurosurgery at Ayub Teaching Hospital Abbottabad from 1st January 2019 to 31st Dec 2021. Inclusion and exclusion criteria were created. The medical record of 116 patients admitted and operated on for traumatic extradural hematoma was retrospectively reviewed. Information was recorded using a standardized structured questionnaire. The outcome was measured in terms of the Glasgow coma outcome score.
UNASSIGNED: Out of 116 patients, 93 were male and 23 were female.19 (16.4%) patients were in the age range 0-5 years, 42 (36.2%) were in the age range 6-15, 35(31.0%) were in the age range 16-30, 11 (9.5%) were in the age range 31-45 years, 7 (6.0%) were in the age range 46-60 years while only one patient included in this study was above 60 years. Overall mortality was 4.3%. Mortality was higher in females and in those aged less than 5 years (3.4%). 4 out of 16 patients died with GCS less than 8, while none of the patients died when GCS was above 12. Mortality was significantly higher in the presence of associated lesions (4.4% vs. 0%) and anisocoria (2.6% vs.1.7%). Patients who operated within 6 hours of trauma resulted in better outcomes with a mortality rate of 0.0% and functional recovery of 57.8 % while for those who operated after 6 hours, mortality was significantly higher (4.3%) and functional recovery was significantly low (15.5%).
UNASSIGNED: Good surgical outcomes can be achieved with early operative intervention if indicated. Female gender, low preoperative GCS score, presence of pupillary dilatation, presence of associated lesions, delayed surgical intervention and age less than 5 years are significant predictors for poor outcomes.
UNASSIGNED: This retrospective study was conducted in the Department of Neurosurgery at Ayub Teaching Hospital Abbottabad from 1st January 2019 to 31st Dec 2021. Inclusion and exclusion criteria were created. The medical record of 116 patients admitted and operated on for traumatic extradural hematoma was retrospectively reviewed. Information was recorded using a standardized structured questionnaire. The outcome was measured in terms of the Glasgow coma outcome score.
UNASSIGNED: Out of 116 patients, 93 were male and 23 were female.19 (16.4%) patients were in the age range 0-5 years, 42 (36.2%) were in the age range 6-15, 35(31.0%) were in the age range 16-30, 11 (9.5%) were in the age range 31-45 years, 7 (6.0%) were in the age range 46-60 years while only one patient included in this study was above 60 years. Overall mortality was 4.3%. Mortality was higher in females and in those aged less than 5 years (3.4%). 4 out of 16 patients died with GCS less than 8, while none of the patients died when GCS was above 12. Mortality was significantly higher in the presence of associated lesions (4.4% vs. 0%) and anisocoria (2.6% vs.1.7%). Patients who operated within 6 hours of trauma resulted in better outcomes with a mortality rate of 0.0% and functional recovery of 57.8 % while for those who operated after 6 hours, mortality was significantly higher (4.3%) and functional recovery was significantly low (15.5%).
UNASSIGNED: Good surgical outcomes can be achieved with early operative intervention if indicated. Female gender, low preoperative GCS score, presence of pupillary dilatation, presence of associated lesions, delayed surgical intervention and age less than 5 years are significant predictors for poor outcomes.
摘要：
■硬膜外血肿是神经外科中最常见的外科急症之一。进行这项研究是为了确定在发展中国家资源有限的情况下接受外伤性颅内硬膜外血肿手术的患者的死亡率和预后因素。
这项回顾性研究于2019年1月1日至2021年12月31日在阿尤布教学医院阿伯塔巴德神经外科进行。建立了纳入和排除标准。回顾性分析了116例因外伤性硬膜外血肿入院和手术的患者的病历。使用标准化的结构化问卷记录信息。根据格拉斯哥昏迷结果评分来衡量结果。
■在116名患者中，男性93例，女性23例。19例（16.4%）患者年龄在0-5岁，42（36.2％）在6-15岁之间，35（31.0％）在16-30岁之间，11（9.5％）在31-45岁之间，7（6.0％）的年龄范围为46-60岁，而本研究中只有一名患者的年龄超过60岁。总死亡率为4.3%。女性和5岁以下人群的死亡率较高（3.4％）。16例患者中有4例GCS低于8例死亡，而GCS高于12例时无一例死亡。在存在相关病变的情况下，死亡率明显更高(4.4%vs.0%)和不适(2.6%vs.1.7%)。在创伤后6小时内手术的患者获得了更好的结果，死亡率为0.0％，功能恢复为57.8％，而在6小时后手术的患者，死亡率显著较高(4.3%),功能恢复显著较低(15.5%).
■如果需要，早期手术干预可以获得良好的手术效果。女性性别,术前GCS评分低，瞳孔扩张的存在，相关病变的存在，手术干预延迟和年龄小于5岁是预后不良的重要预测因素.
这项回顾性研究于2019年1月1日至2021年12月31日在阿尤布教学医院阿伯塔巴德神经外科进行。建立了纳入和排除标准。回顾性分析了116例因外伤性硬膜外血肿入院和手术的患者的病历。使用标准化的结构化问卷记录信息。根据格拉斯哥昏迷结果评分来衡量结果。
■在116名患者中，男性93例，女性23例。19例（16.4%）患者年龄在0-5岁，42（36.2％）在6-15岁之间，35（31.0％）在16-30岁之间，11（9.5％）在31-45岁之间，7（6.0％）的年龄范围为46-60岁，而本研究中只有一名患者的年龄超过60岁。总死亡率为4.3%。女性和5岁以下人群的死亡率较高（3.4％）。16例患者中有4例GCS低于8例死亡，而GCS高于12例时无一例死亡。在存在相关病变的情况下，死亡率明显更高(4.4%vs.0%)和不适(2.6%vs.1.7%)。在创伤后6小时内手术的患者获得了更好的结果，死亡率为0.0％，功能恢复为57.8％，而在6小时后手术的患者，死亡率显著较高(4.3%),功能恢复显著较低(15.5%).
■如果需要，早期手术干预可以获得良好的手术效果。女性性别,术前GCS评分低，瞳孔扩张的存在，相关病变的存在，手术干预延迟和年龄小于5岁是预后不良的重要预测因素.
