Ryan Schubert
The rising costs and incidence of traumatic subdural hematomas in the United States.
Traumatic subdural hematomas are most often characterized by the acute onset of traumatic bleeding into the space between the dural and arachnoid membranes, typically within hours and by definition always following head injury. A smaller proportion of traumatic SDH will present in a chronic manner, with insidious development of SDH after 3 or more days. In this study, we gathered evidence from the Nationwide Inpatient Sample, the largest all-payer database of nonfederal community hospitals. We defined trends in costs and incidence of traumatic SDH and created a multivariate logistic regression model to analyze how patient age, number of presenting comorbidities, coma status, and treatment location affected mortality following treatment.
This study provided the first national analysis of traumatic SDH for the United States, and established a baseline mortality rate of 14%. We identified the presence of 3 or more comorbidities and the presence of coma as adverse prognostic factors affecting mortality. Finally, our data documented large increases in both charges (67% increase) and incidence (>100% increase) in traumatic SDH over the period of 1993-2006. We speculate in our discussion that the increasing use of anticoagulation therapy may be responsible for the increased incidence.
- Started on: 11/1/2010
- Ended on: 11/1/2011
- Institution/Organization:Stanford University
- Location:Stanford, CA
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