Description
- Abstract:
- Acute subdural hemorrhage (SDH) is a life-threatening bleed between the dura and the brain. It constitutes more than 12% of all traumatic brain injuries [1]. This study seeks to quantify the effects of various factors on patient outcomes in acute SDH. 50 patients with acute SDH admitted to Rhode Island Hospital in 2010 were randomly selected retrospectively from the trauma registry. The patient disposition categories were "Death/Hospice," "Nursing/Rehab," and "Home." SDH volumes at multiple locations and midline shifts were measured by CT as shown in Figure 1. Logistic regressions were performed for all possible combinations of variables. The best models were selected using the Akaike information criterion (∆AIC = 2). The most conservative model within this subset was chosen for interpretation. Our model-selection process removed from consideration the variables: sex, epidural hemorrhage, subarachnoid hemorrhage, intraparenchymal hemorrhage, falcine SDH volume, midline shift distance, and craniotomy. Variables kept by our process are listed in Table 1 with associated odds ratios, 95% confidence intervals, and p-values. Variables that had a statistically significant (p < 0.05) impact on disposition are highlighted. The relative effects of real-valued variables on disposition are shown in Figure 2. Removal of a variable from our model indicates it has little independent effect when controlling for the included variables. Platelets and ventriculostomy may not have had a significant effect on disposition due to the small number of patients in our sample given these treatments. The convexity was the only SDH location that demonstrated a significant negative trend with outcome as similarly demonstrated by [2]. Even accounting for injury size, blood pressure and blood alcohol were negatively associated with outcome. We hypothesize these variables may inhibit clotting, leading to greater bleed expansion.
- Notes:
- Scholarly concentration: Non-Scholarly Concentrator
Access Conditions
- Use and Reproduction
-
- This work is licensed under a Creative Commons Attribution 4.0 International License
Citation
Powers, Andrew Y., Carnevale, Joseph A., and Asaad, Wael A.,
"Volumetric Modeling of Patient Dispositions in Acute Subdural Hemorrhage"
(2016).
Warren Alpert Medical School Academic Symposium.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:697405/
Relations
Collection:
-
Warren Alpert Medical School Academic Symposium
The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …...