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Scandinavian Multicenter Acute Subdural Hematoma (SMASH) Study: Study Protocol for a Multinational Population-Based Consecutive Cohort.

Journal article
Authors Jiri Bartek
Christian Laugesen
Sadia Mirza
Axel Forsse
Michael Anders Petersen
Alba Corell
Philip Wilhelm Dyhrfort
Henrietta Nittby Redebrandt
Linus Reen
Shaian Zolfaghari
Lovisa Tobieson
Björn Carlsvärd
Bo Bergholt
Asma Bashir
Preben Soerensen
Arzu Bilgin
Conny Johansson
Peter Lindvall
Petter Förander
Bo-Michael Bellander
Jacob B Springborg
Asgeir Store Jakola
Published in Neurosurgery
Volume 84
Issue 3
Pages 799–803
ISSN 1524-4040
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 799–803
Language en
Links dx.doi.org/10.1093/neuros/nyy173
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Neurosurgery, Traumatology

Abstract

Traumatic acute subdural hematomas (ASDHs) are associated with high rate of morbidity and mortality, especially in elderly individuals. However, recent reports indicate that the morbidity and mortality rates might have improved.To evaluate postoperative (30-d) mortality in younger vs elderly (≥70 yr) patients with ASDH. Comparing younger and elderly patients, the secondary objectives are morbidity patterns of care and 6 mo outcome according to Glasgow outcome scale (GOS). Finally, in patients with traumatic ASDH, we aim to provide prognostic variables.This is a large-scale population-based Scandinavian study including all neurosurgical departments in Denmark and Sweden. All adult (≥18 yr) patients surgically treated between 2010 and 2014 for a traumatic ASDH in Denmark and Sweden will be included. Identification at clinicaltrials.gov is NCT03284190.We expect to provide data on potential differences between younger vs elderly patients in terms of mortality and morbidity. We hypothesize that elderly patients selected for surgery have a similar pattern of care as compared with younger patients. We will provide functional outcome in terms of GOS at 6 mo in younger vs elderly patients undergoing ASDH evacuation. Finally, clinical useful prognostic factors for favorable (GOS 4-5) vs unfavorable (GOS 1-3) will be identified.An improved understanding of the clinical outcome, treatment and resource allocation, clinical course, and the prognostic factors of traumatic ASDH will allow neurosurgeons to make better treatment decisions.

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