Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Patient Selection
2.2. Data Items
2.3. Statistical Analysis
2.4. Data Availability
3. Results
3.1. Cohort Characteristics
3.2. Predictors of Mortality in Patients with Subdural Hematoma
3.3. Moderate-to-Severe Subdural Hematoma Mortality Score
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (29,915) | Discharged (17,780, 59.4%) | Inpatient Death (12,135, 40.6%) | OR (95% CI) | p Value | |
---|---|---|---|---|---|
Demographics | |||||
Age > 70 | 10,860 (36.3%) | 5165 (29%) | 5695 (46.9%) | 2.16 (2.06–2.27) | <0.001 |
Female | 10,550 (35.3%) | 6085 (34.2%) | 4465 (36.8%) | 1.12 (1.07–1.17) | <0.001 |
Caucasian | 17,735 (59.3%) | 10,260 (57.7%) | 7475 (61.6%) | 1.18 (1.12–1.23) | <0.001 |
Public Insurance | 19,125 (63.9%) | 10,970 (61.7%) | 8155 (67.2%) | 1.27 (1.21–1.34) | <0.001 |
Clinical Comorbidities | |||||
Long-term Anticoagulation | 3630 (12.1%) | 1505 (8.5%) | 2125 (17.5%) | 2.30 (2.14–2.46) | <0.001 |
Diabetes mellitus | 4475 (15%) | 2270 (12.8%) | 2205 (18.2%) | 1.52 (1.42–1.62) | <0.001 |
Hyperlipidemia | 4655 (15.6%) | 2640 (14.8%) | 2015 (16.6%) | 1.14 (1.07–1.22) | <0.001 |
Hypertension | 10,630 (35.5%) | 6220 (35%) | 4410 (36.3%) | 1.06 (1.01–1.11) | <0.001 |
Obesity | 825 (2.8%) | 455 (2.6%) | 370 (3%) | 1.20 (1.04–1.38) | <0.001 |
Clinical Characteristics | |||||
Hyponatremia | 3255 (10.9%) | 2460 (13.8%) | 795 (6.6%) | 0.44 (0.40–0.48) | <0.001 |
Cardiac Arrest | 1230 (4.1%) | 135 (0.8%) | 1095 (9%) | 12.96 (10.82–15.57) | <0.001 |
Seizures | 2295 (7.7%) | 1705 (9.6%) | 590 (4.9%) | 0.48 (0.44–0.53) | <0.001 |
Clinical Severity Variables | |||||
Mechanical Ventilation | 13,935 (46.6%) | 7785 (43.8%) | 6150 (50.7%) | 1.32 (1.26–1.38) | <0.001 |
Hydrocephalus | 740 (2.5%) | 370 (2.1%) | 370 (3%) | 1.48 (1.28–1.71) | <0.001 |
Herniation | 6955 (23.2%) | 2780 (15.6%) | 4175 (34.4%) | 2.83 (2.68–2.99) | <0.001 |
Hemiplegia | 2700 (9%) | 2040 (11.5%) | 660 (5.4%) | 0.44 (0.41–0.49) | <0.001 |
Aphasia | 1670 (5.6%) | 1425 (8%) | 245 (2%) | 0.24 (0.21–0.27) | <0.001 |
Variable | OR (95% CI) | p Value |
---|---|---|
Female | 0.95 (0.90–0.99) | 0.032 |
Age > 70 | 2.24 (2.12–2.36) | <0.001 |
Caucasian | 1.02 (0.97–1.07) | 0.387 |
Public Insurance | 0.92 (0.88–0.98) | <0.001 |
Q1 Median Income | 0.96 (0.91–1.01) | 0.114 |
Variable | OR (95% CI) | p Value |
---|---|---|
Long-term anticoagulation | 2.08 (1.97–2.20) | <0.001 |
Diabetes Mellitus | 1.66 (1.54–1.79) | <0.001 |
Hyperlipidemia | 0.81 (0.75–0.87) | <0.001 |
Hypertension | 0.84 (0.80–0.89) | <0.001 |
Obesity | 1.12 (0.97–1.30) | 0.137 |
Mechanical Ventilation | 1.44 (1.37–1.52) | <0.001 |
Hydrocephalus | 1.28 (1.09–1.49) | <0.001 |
External ventricular drain | 0.93 (0.85–1.02) | 0.111 |
Hyponatremia | 0.45 (0.41–0.49) | <0.001 |
Herniation | 2.64 (2.50–2.80) | <0.001 |
Non-epileptic Seizure | 0.51 (0.46–0.56) | <0.001 |
Status Epilepticus | 0.78 (0.61–0.99) | 0.043 |
B Coefficient | OR (95% CI) | p Value | Weighted Coefficient | |
---|---|---|---|---|
Female | −0.05 | 0.90 (0.90–1.00) | 0.061 | |
Age > 70 | 0.84 | 2.32 (2.19–2.47) | <0.001 | 1 |
Public Insurance | −0.09 | 0.91 (0.86–0.96) | <0.001 | |
Long Term Steroids | −0.34 | 0.71 (0.53–0.95) | 0.022 | |
Diabetes mellitus | 0.23 | 1.26 (1.17–1.35) | <0.001 | 1 |
Hyperlipidemia | −0.19 | 0.82 (0.77–0.89) | <0.001 | |
Hypertension | −0.18 | 0.84 (0.80–0.89) | <0.001 | |
Mechanical Ventilation | 0.36 | 1.44 (1.37–1.51) | <0.001 | 1 |
Hydrocephalus | 0.24 | 1.27 (1.09–1.49) | <0.001 | 1 |
Hyponatremia | −0.80 | 0.45 (0.41–0.49) | <0.001 | |
Herniation | 0.99 | 2.69 (2.54–2.85) | <0.001 | 1 |
Seizures | −0.68 | 0.51 (0.46–0.56) | <0.001 | |
Status Epilepticus | −0.23 | 0.79 (0.62–1.01) | 0.064 |
Variable | Coefficient |
---|---|
Age > 70 | 1 |
Diabetes mellitus | 1 |
Mechanical Ventilation | 1 |
Hydrocephalus | 1 |
Herniation | 1 |
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Vazquez, S.; Jain, A.K.; Nolan, B.; Spirollari, E.; Clare, K.; Thomas, A.; Soldozy, S.; Ali, S.; Sukul, V.; Rosenberg, J.; et al. Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma. Life 2024, 14, 1049. https://doi.org/10.3390/life14081049
Vazquez S, Jain AK, Nolan B, Spirollari E, Clare K, Thomas A, Soldozy S, Ali S, Sukul V, Rosenberg J, et al. Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma. Life. 2024; 14(8):1049. https://doi.org/10.3390/life14081049
Chicago/Turabian StyleVazquez, Sima, Aarti K. Jain, Bridget Nolan, Eris Spirollari, Kevin Clare, Anish Thomas, Sauson Soldozy, Syed Ali, Vishad Sukul, Jon Rosenberg, and et al. 2024. "Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma" Life 14, no. 8: 1049. https://doi.org/10.3390/life14081049