Journal of Korean Society of Geriatric Neurosurgery 2015;11(1):24-30.
Published online June 30, 2015.
Analysis of Risk Factors for the Postoperative Epidural Hematoma after Intracranial Surgery in Elderly Patients
Wonjun Moon , Hyoung Kyun Rha , Hae Kwan Park , Chung Kee Chough, Kyung Jin Lee , Seunghwa Jeong
Department of Neurosurgery, Yeouido St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
두개내 수술 후 발생한 경막외 출혈의 위험 인자에 대한 분석
문원준·나형균·박해관·조정기·이경진·정승화
가톨릭대학교 의과대학 여의도성모병원 신경외과학교실
Abstract
Objective
As the elderly people increased, the incidence of traumatic brain injury, brain tumor, cerebrovascular accidence increased in geriatric peoples. Sometimes, the operation is needed. And the complication is more severe in geriatric peoples. Postoperative epidural hematomas (EDH) is a relatively common complication in intracranial operations. In this study, we analyzed the risk factors associated with the occurrence of postoperative EDH in geriatric peoples.
Methods
This study is a retrospective study of 19 (2.4%) patients who were over sixty-five years old that underwent postoperative EDH after intracranial surgery between January 2010 and December 2014. During this period, 871 intracranial operations were performed. We analyzed the data by using SPSS 21.0.
Results
The postoperative EDH was occurred 19 and their average age was 71.4 years. Univariate analysis showed that risk factors associated with post-operative EDH were a pre-operative Glasgow Coma Scale (GCS) scored <8 (crude odds ratio 8.241), prothrombin ratio >1.0 (p=0.016), prothrombin time (PT) >11.3 sec (p=0.009), intra-operative blood loss >700mL (p=0.004) and craniotomy size >7,850mm2 (p=0.019). In multivariate analysis, intra-operative blood loss exceeding 700mL associated with postoperative EDH occurrence.
Conclusion
To reduce the postoperative complication in elderly patients, we suggested the risk factors that associated the postoperative EDH as large intra-operative blood loss, wide craniotomy area, prolonged PT and a pre-operative GCS <8.
Key Words: Intracranial epidural hematomaㆍDecompressive craniectomyㆍCraniotomyㆍRisk factors


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