Short and long-term geriatric mortality after acute traumatic subdural hemorrhage

Abstract Background Acute subdural hemorrhage often occurs in those ≥65 years of age after trauma and tends to yield poor clinical outcomes. Previous studies have demonstrated a propensity toward high in-hospital mortality rates in this population; however, post-discharge mortality data is limited. The objective of the present study was to analyze short and long-term mortality data after acute traumatic subdural hemorrhage in the geriatric population as well as review the impact of associated clinical variables including mechanism of injury, pre-morbid antithrombotic use, and need for surgical decompression on mortality rates. Methods We retrospectively reviewed 455 patients who presented with an isolated traumatic acute subdural hemorrhage to our level-1 trauma center utilizing our data registry. Patients were then cross-referenced in the National Social Security Death Index for post-discharge mortality rates. United States life tables were utilized for peer-controlled actuarial comparisons. Results Acute traumatic subdural hemorrhage is often a fatal injury in the geriatric population, especially if taking antithrombotics or requiring surgical decompression. Specifically, they have higher in-hospital mortality rates than adults with similar injuries and have significantly lower survival rates for several years following discharge compared to their peer-matched controls. Conclusions Here, we found that age is a significant predictor of both short and long-term survival after acute traumatic subdural hemorrhage. Moreover, the present study corroborates that the need for surgical decompression or the use of pre-morbid antithrombotic medications is associated with increased overall mortality.