Traumatic Intracranial Haematomas In Elderly Related To Its Outcome.
TRAUMATIC INTRACRANIAL HAEMATOMAS IN ELDERLY RELATED TO ITS
OUTCOME
Sevline Estethia O, M.Z. Arifin
Department of Neurosurgery, Hasan Sadikin Hospital, Padjadjaran University,Bandung,
Indonesia
ABSTRACT
Background : Management of traumatic brain injury in elderly gives dilemma situations
in neurosurgery. They often have complexities in pre-existing medical conditions and other
considerations. The benefit of both surgery or non-surgery intervention in traumatic intracranial
haematomas is controversy because of its poorer outcomes.
Objectives : We want to record factors influencing outcome in elderly patient with
traumatic intracranial haematomas.
Methods : Data was recorded retrospectively from medical records in 2009 until 2010.
All trauma patients over the age 60 with traumatic intracranial haematomas confirmed by head
CT scan are included in this study. We record patients’ demographic data, diagnosis, mechanism
of injury, GCS admission, other associated injuries, pre-existing disease, treatment, GCS
discharge, mortality and length of hospitality. Outcome categorized in GCS discharge, length of
stay in hospital, and mortalities. Data was analyzed statistically using SPSS 13.0 version.
Results : We found 40 cases included in this study, 32 cases (80%) were male and 8
cases (20%) were female with average age was 69.38 ± 4.68 years old. The most common cause
of injury was pedestrian struck by motorcycle (47,5%). There were 4 (10%) cases with
intracerebral haematomas, 2 cases (5%) with epidural haematomas, 1 case (2,5%) with subdural
haematomas, 1 case (2,5%) with cerebral contusion, and 32 cases (80%) with multiple
intracranial haematomas. 37,5% cases were treated by surgery. Mortality were 37,5% and most
common in 60-65 years old (17,5%). Most influencing factor in mortality is intracerebral
haematoma with OR = 5.09. GCS admission 14-15 and intraventricular haemorrhage are
protective of mortality with OR 65 tahun yang
mengalami trauma dengan perdarahan intrakranial dan dikonfirmasi dengan pemeriksaan CT
scan kepala . Data yang direkam antara lain data demografis, diagnosis, mekanisme cedera, GCS
pada waktu masuk rumah sakit, adanya cedera organ lain, penyakit klinis sebelumnya,
penatalaksanaan, GCS pulang, kematian, dan lamanya perawatan. Hasil akhir dikategorikan
menjadi GCS pulang, lamanya perawatan, dan kematian. Data dianalisis secra statistic
menggunakan SPSS versi 13.0.
Hasil : Kami mendapatkan 40 kasus pada penelitian ini dimana 32 kasus (80%) laki-laki
dan 8 kasus (20%) perempuan dengan rata-rata umur 69.38 ± 4.68 tahun. Penyebab cedera
tersering adalah pejalan kaki yang ditabrak sepeda motor (47,5%). Terdapat 4 kasus (10%)
dengan perdarahan intracerebral, 2 kasus (5%) dengan perdarahan epidural, 1 kasus (2,5%)
dengan perdarahan subdural, 1 kasus (2,5%) dengan kontusio otak, dan 32 kasus (80%) dengan
perdarahan intrakranial multipel. 37,5% kasus ditangani dengan pembedahan. Kematian terjadi
pada 37,5%, terutama pada kelompok umur 60-65 tahun (17,5%). Faktor yang sangat
berpengaruh terhadap kematian adalah perdarahan intraserebral dengan OR = 5.09. GCS pada
waktu masuk rumah sakit sebesar 14-15 dan perdarahan intraventrikel bersifat protektif terhadap
kematian dengan OR
OUTCOME
Sevline Estethia O, M.Z. Arifin
Department of Neurosurgery, Hasan Sadikin Hospital, Padjadjaran University,Bandung,
Indonesia
ABSTRACT
Background : Management of traumatic brain injury in elderly gives dilemma situations
in neurosurgery. They often have complexities in pre-existing medical conditions and other
considerations. The benefit of both surgery or non-surgery intervention in traumatic intracranial
haematomas is controversy because of its poorer outcomes.
Objectives : We want to record factors influencing outcome in elderly patient with
traumatic intracranial haematomas.
Methods : Data was recorded retrospectively from medical records in 2009 until 2010.
All trauma patients over the age 60 with traumatic intracranial haematomas confirmed by head
CT scan are included in this study. We record patients’ demographic data, diagnosis, mechanism
of injury, GCS admission, other associated injuries, pre-existing disease, treatment, GCS
discharge, mortality and length of hospitality. Outcome categorized in GCS discharge, length of
stay in hospital, and mortalities. Data was analyzed statistically using SPSS 13.0 version.
Results : We found 40 cases included in this study, 32 cases (80%) were male and 8
cases (20%) were female with average age was 69.38 ± 4.68 years old. The most common cause
of injury was pedestrian struck by motorcycle (47,5%). There were 4 (10%) cases with
intracerebral haematomas, 2 cases (5%) with epidural haematomas, 1 case (2,5%) with subdural
haematomas, 1 case (2,5%) with cerebral contusion, and 32 cases (80%) with multiple
intracranial haematomas. 37,5% cases were treated by surgery. Mortality were 37,5% and most
common in 60-65 years old (17,5%). Most influencing factor in mortality is intracerebral
haematoma with OR = 5.09. GCS admission 14-15 and intraventricular haemorrhage are
protective of mortality with OR 65 tahun yang
mengalami trauma dengan perdarahan intrakranial dan dikonfirmasi dengan pemeriksaan CT
scan kepala . Data yang direkam antara lain data demografis, diagnosis, mekanisme cedera, GCS
pada waktu masuk rumah sakit, adanya cedera organ lain, penyakit klinis sebelumnya,
penatalaksanaan, GCS pulang, kematian, dan lamanya perawatan. Hasil akhir dikategorikan
menjadi GCS pulang, lamanya perawatan, dan kematian. Data dianalisis secra statistic
menggunakan SPSS versi 13.0.
Hasil : Kami mendapatkan 40 kasus pada penelitian ini dimana 32 kasus (80%) laki-laki
dan 8 kasus (20%) perempuan dengan rata-rata umur 69.38 ± 4.68 tahun. Penyebab cedera
tersering adalah pejalan kaki yang ditabrak sepeda motor (47,5%). Terdapat 4 kasus (10%)
dengan perdarahan intracerebral, 2 kasus (5%) dengan perdarahan epidural, 1 kasus (2,5%)
dengan perdarahan subdural, 1 kasus (2,5%) dengan kontusio otak, dan 32 kasus (80%) dengan
perdarahan intrakranial multipel. 37,5% kasus ditangani dengan pembedahan. Kematian terjadi
pada 37,5%, terutama pada kelompok umur 60-65 tahun (17,5%). Faktor yang sangat
berpengaruh terhadap kematian adalah perdarahan intraserebral dengan OR = 5.09. GCS pada
waktu masuk rumah sakit sebesar 14-15 dan perdarahan intraventrikel bersifat protektif terhadap
kematian dengan OR