Outcome Of Traumatic Extradural Hematoma- A Prospective Analysis

Research Article
Birla Rahul Sanjay., Wilkinson T.Raju Vinay., Hazara Abhijit Fulare Sushrut and Akhtar Murtaza
DOI: 
http://dx.doi.org/10.24327/ijrsr.2019.1002.3183
Subject: 
Medicine
KeyWords: 
Extradural hematoma (EDH), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Traumatic brain injury (TBI).
Abstract: 

Introduction: Epidural hematoma accounts for 1% to 2% of Traumatic Brain Injury and 5% to 15% of fatality. Aims: A study was to determine prognostic factors affecting the outcome in patients with extradural hematoma in a rural set up. Settings and Design: prospective of study was carried out at the department of surgery in a rural based tertiary care hospital from October 2012 to October 2014. Methods and Material: Patients admitted with extradural hematoma diagnosed on imaging study [plain computed tomography of brain] were included in study. Patients with associated life threatening injuries such as intra-abdominal, intrathoracic and pelvic injuries were excluded from the study. A total of 58 cases were diagnosed as extradural hematoma on imaging study. 5 patients were excluded. Thus, 53 patients were included in study. Demographic data, history, mode of trauma, examination findings, investigations and outcome were recorded. Glasgow coma scale was used for initial assessment and Glasgow outcome scale was applied at the time of discharge to assess outcome in terms of neurological recovery in all patients. Statistical analysis : Univariate and multivariate analysis were performed using statistical software 13.1. Results: Maximum percentage of patients belonged to age group 21-30 years (37.74%). Males (38) were more commonly affected than female (15) with ratio of 2.5:1. Commonest mode of injury was a road traffic accident (73.58%) followed by fall (24.53%) and assault (1.89%). In Univariate analysis, heart rate on admission, presence of neuro-motor deficit, Glasgow coma scale score on admission, volume of hematoma, pupillary changes, presence of depressed skull fractures, temporal site of skull fracture and presence of midline shift were statistically significant with outcome. In multivariate analysis, Glasgow coma scale score on admission and volume of hematoma were independent prognostic factor for outcome. Conclusions: In India rural setup, predominantly young males are affected. Road traffic accident was the most common cause of injury. GCS on admission and volume of hematoma were most important independent predictors of outcome.