• Ching-Hua Hsieh, Cheng-Shyuan Rau, Shao-Chun Wu, Hang-Tsung Liu, Chun-Ying Huang, Shiun-Yuan Hsu, and Hsiao-Yun Hsieh.
• Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan. m93chinghua@gmail.com.
• Int J Environ Res Public Health. 2018 Nov 1; 15 (11).

BackgroundWe aimed to explore the risk factors that contribute to the mortality of elderly trauma patients with acute subdural hematoma (SDH) resulting from a fall. Mortality rates of the elderly were compared to those of young adults.MethodsA total of 444 patients with acute traumatic subdural hematoma resulting from a fall, admitted to a level I trauma center from 1 January 2009 to 31 December 2016 were enrolled in this study. Patients were categorized into two groups: elderly patients (n = 279) and young adults (n = 165). The primary outcome of this study was patient mortality in hospital. The adjusted odds ratio (AOR) with 95% confidence interval (CI) for mortality was calculated according to gender and pre-existing comorbidities. Univariate and multivariate logistic regression analyses were performed to identify factors related to mortality in the elderly.ResultsThe odds ratio for mortality caused by falls in the elderly patients was four-fold higher than in the young adults, after adjusting for gender and pre-existing comorbidities. In addition, the presence of pre-existing coronary artery disease (OR 3.2, 95% CI 1.09⁻9.69, p = 0.035), end-stage renal disease (OR 4.6, 95% CI 1.48⁻14.13, p = 0.008), hematoma volume (OR 1.2, 95% CI 1.11⁻1.36, p < 0.001), injury severity score (OR 1.3, 95% CI 1.23⁻1.46, p < 0.001), and coagulopathy (OR 4.0, 95% CI 1.47⁻11.05, p = 0.007) were significant independent risk factors for mortality in patients with acute traumatic SDH resulting from a fall.ConclusionsIn this study, we identified that pre-existing CAD, ESRD, hematoma volume, ISS, and coagulopathy were significant independent risk factors for mortality in patients with acute traumatic SDH. These results suggest that death following acute SDH is influenced both by the extent of neurological damage and the overall health of the patient at the time of injury.

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