Outcome of Surgically Treated Traumatic Extradural Hematoma

Abstract

Summary: Extradural hematoma (EDH) has been seen as a neurosurgical emergency since eighteenth century. Efforts have been on since then to reduce the mortality associated with this entity. The mortality has dropped from around 80% in late nineteenth and early twentieth centuries to below 20% in many centers now. Improving quality of care and, constant assessment of outcome and factors affecting outcome are the driving forces leading to reduction in mortality. Objectives: To determine the functional outcome and the effect of level of consciousness on traumatic extradural hematoma patients who had surgery in our centers. Patients and Methods: It was a prospective observational study carried out on forty three patients with traumatic extradural hematoma who had surgical evacuation of the hematomas in our centers over a five year period. Data were collected using structured proforma in accident and emergency, theater, intensive care unit, wards and in outpatient clinic. The data were analyzed using Environmental Performance Index (EPI) info 2007 software. Results: Forty three patients had surgery for traumatic extradural hematoma during the five year period. There were thirty eight males (88.37%) and five females (11.63%). Road traffic accident was the most common aetiology. The functional outcome was 83.72% and mortality was 13.95%. Glasgow Coma Score prior to surgery and age significantly affected the outcome, P = .002 and P = .00 respectively. Conclusion: The favorable functional outcome from our study (83.72%) was within the current range in the world. Level of consciousness prior to surgery and age significantly affected outcome.