TRAUMATIC ACUTE SUBDURAL-HEMATOMA - MAJOR MORTALITY REDUCTION IN COMATOSE PATIENTS TREATED WITHIN 4 HOURS
TRAUMATIC ACUTE SUBDURAL-HEMATOMA - MAJOR MORTALITY REDUCTION IN COMATOSE PATIENTS TREATED WITHIN 4 HOURS
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DOI：
10.1056/nejm198106183042503
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发表时间：
1981-01-01
影响因子：
158.5
通讯作者：
CHOI, SC
中科院分区：
文献类型：
--
作者：
SEELIG, JM;BECKER, DP;CHOI, SC
为了发现哪些因素有助于手术颅内减压后的恢复，82例外伤性急性硬膜下血肿（ASDH）昏迷患者的记录进行了研究，这些患者在一个单一的中心根据统一的协议进行治疗。从受伤到手术的延迟是最重要的治疗因素。在前4小时内接受手术的患者死亡率为30%，而在4小时后接受手术的患者死亡率为90%（P < 0.0001）。其他重要的预后变量包括最初的神经系统检查结果、性别、多模态诱发电位和术后颅内压。如果所有创伤性ASDH患者在受伤后4小时内直接被送往有能力诊断和清除血肿的医院，死亡率可以大大降低。
To discover which factors contributed to recovery after surgical intracranial decompression, the records of 82 comatose patients with traumatic acute subdural hematoma (ASDH) who were treated in a single center under a uniform protocol were studied. The delay from injury to operation was the factor of greatest therapeutic importance. Patients who underwent surgery within the first 4 h had a 30% mortality rate, compared to 90% in those who had surgery after 4 h (P < 0.0001). Other important prognostic variables included results of the initial neurologic examination, sex, multimodality-evoked potentials and postoperative intracranial pressure. If all patients with traumatic ASDH were taken directly to hospitals equipped to diagnose and remove the hematoma within 4 h of injury, mortality rates could be reduced considerably.