Journal of Korean Society of Geriatric Neurosurgery 2014;10(1):1-6.
Published online June 30, 2014.
Clinical Features and Surgical Outcome of Acute Subdural Hematoma in the Elderly above 65 Years
Do Young Han , Cheol Su Jwa
Department of Neurosurgery, National Medical Center, Seoul, Korea
65세 이상 노인에서 급성 경막하 혈종의 임상 양상과 수술적 치료의 결과
한도영·좌철수
국립중앙의료원 신경외과
Abstract
Objective
We investigated clinical features and surgical outcomes of acute subdural hematoma in elderly patients above 65 years Methods: The consecutive 154 patients treated with acute subdural hematoma between January 2010 to December 2012 analyzed retrospectively; elderly group above 65 years (n=57) and control group below 65 years (n=97). Clinical features, Glasgow outcome scale (GOS) at discharge, in-hospital morbidity and mortality were assessed. Surgical outcome and postoperative complications were compared with the control group. Results: Fall (50%) was the most common mechanism of acute subdural hematoma in the elderly patients. Elderly patients undergone surgery were smaller than the control group (17.5% vs. 37.1%, p=0.011). Overall outcomes were not statistically significant different between the elderly and younger patients. However, in-hospital mortality after surgery was much worse in the elderly (50.0%) than younger patients (19.4%) (p=0.052). Postoperative complications such as pneumonia and pulmonary edema were more frequent in the elderly than in younger patients although it is not statistically significant (respectively, p=0.052, p=0.066). Conclusion: The elderly above 65 years may have worse outcome following surgery of acute subdural hematoma, which may be due to frequent postoperative complications. Surgery of acute subdural hematoma in the elderly should be individualized after considering general condition and associated medical illnesses.
Key Words: Acute subdural hematomaㆍElderlyㆍOutcome


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