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Objective: To eluciadate changing outcomes in elderly patients sustaining traumatic subdural hematoma at a single institution
Design:Retrospective chart review of the past 11 years (2000-2010) of all patients > 65 years old sustaining traumatic subdural hematomas
Setting: Academic Level I Trauma Center
Patients: All patients, greater than 65 years of age sustaining traumatic subdural hematoma (545 patients)
Interventions:Operative versus non operative management
Main Outcome Measures: Mortality; Discharge Disposition
Results: 19% of patients sustaining a traumatic subdural hematoma in the last 11 years (2000-2010) are elderly (>65 years old) with the majority (82%) suffering a fall mechanism, Few patients are operativel managed (10%); those that are operated on have a higher mortality than those that are not (40% vs 26%). Over these past 11 years overall mortality has steadily decreased from 50% to 10-25%. At hospital discharge 32% go to rehab; 20% go home and 20% are admitted to skilled nursing facilities.
Conclusions: As opposed to earlier published results, traumatic subdural hematoma does no longer carry an abysmal outcome expectation. Non operative mangement is the norm and with careful, aggressive intensive neurologic care close to 75% may expect to be discharged from the hospital.