Prognostic factors and long-term outcomes of surgically treated acute SDH in a tertiary centre of developing country a prospective observational study

Abstract

Abstract Backgrounds Acute traumatic subdural hematoma (SDH) can be a life-threatening neurosurgical emergency that necessitates immediate evacuation. Predictor data for functional outcomes are scarce and mostly retrospective. The purpose of this prospective research is to evaluate the clinical presentation, risk factors, and final outcomes of SDH patients who underwent surgical intervention. Methodology A prospective observational study was conducted on a consecutive series of patients with surgically treated subdural hematoma (SDH) from November 2022 to March 2023. A comparison was made between individuals with favourable and unfavourable 3-month outcomes (as measured by the Glasgow Outcome Scale [GOS] 0–3 versus 4–5) in terms of baseline clinical data, hospital and surgical course, complications, and imaging data. A multivariable logistic regression model was developed in order to determine the independent predictors of good outcomes. The nomogram was constructed by applying the model. Results 101 SDH patients were surgically managed and followed up for 3 months. The admission GCS, haemoglobin, BUN, presence of brain bulge, and other associated injuries were found to be significantly different between good and poor outcome patients. The presence of a brain bulge was found to be significant in the multivariate model. A score of 30 can ensure a good functional outcome with a 95% probability. Conclusion The authors anticipate that the findings from this study, conducted at a single institution are helpful in preoperative discussions with patients and their families. These insights specifically pertain to the anticipated postoperative outcomes following the surgical evacuation of SDH.