Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma

Authors

Sima Vazquez, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Aarti K. Jain, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Bridget Nolan, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Eris Spirollari, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Kevin Clare, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Anish Thomas, Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA.
Sauson Soldozy, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA.
Syed Ali, Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA.Follow
Vishad Sukul, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY 10595, USA.
Jon Rosenberg, Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA.
Stephan Mayer, Department of Neurology, Westchester Medical Center, Valhalla, NY 10595, USA.
Rakesh Khatri, Department of Neurology, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX 79409, USA.
Brian T. Jankowitz, Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Justin Singer, Department of Neurological Surgery, Spectrum Health, Grand Rapids, MI 49503, USA.
Chirag Gandhi, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Fawaz Al-Mufti, School of Medicine, New York Medical College, Valhalla, NY 10595, USA.Follow

Author Type(s)

Student, Resident/Fellow, Faculty

DOI

10.3390/life14081049

Journal Title

Life

Document Type

Article

Publication Date

8-22-2024

Department

Neurology

Second Department

Neurosurgery

Abstract

As the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score. Of 29,915 patients admitted with moderate-to-severe subdural hematomas, 12,135 (40.6%) died within the same hospital admission. In a multivariate model of relevant demographic and clinical covariates, age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were independent predictors of mortality (p < 0.001 for all). Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were assigned a "1" in a weighted mortality score. The ROC curve for our model showed an area under the curve of 0.64. Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were predictive of mortality. We created the first clinically relevant weighted mortality score that can be used to stratify risk, guide prognosis, and inform family discussions.

Recommended Citation

Vazquez, S., Jain, A. K., Nolan, B., Spirollari, E., Clare, K., Thomas, A., Soldozy, S., Ali, S., Sukul, V., Rosenberg, J., Mayer, S., Khatri, R., Jankowitz, B. T., Singer, J., Gandhi, C., & Al-Mufti, F. (2024). Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma. Life, 14 (8). https://doi.org/10.3390/life14081049