James AD Berry1*, Peymon Mohamadi2, Joseph V. Davis1, Daniel E. Miulli1 and Fanglong Dong2
1Department of Neurological Surgery, Arrowhead Regional Medical Center, USA
2Department of Neurological Surgery, Western University of Health Sciences, USA
The purpose of this study is to discern the degree of increased morbidity & mortality from traumatic subdural hematomas due to ground level falls while taking anticoagulation. All ground level falls have an approximately similar level of force and impact providing a consistent degree of injury. This study will compare patients on anticoagulation vs. those who are not on anticoagulation. This study compares the radiologic criteria of total subdural volume, degree of midline shift, and maximal diameter of the subdural hematoma. This study will also asses the patients presenting neurological status including GCS and focal deficits. Finally, this study will also asses the need for invasive interventions such as subdural drain placement and emergent decompressive craniotomy for evacuation of subdural hematoma. This was a retrospective study with all information obtained from an American College of Surgeons certified level II trauma center with a high volume of annual traumatic brain injuries. This study may be used for the future recommendations of trauma alert guidelines to be issued for patients with traumatic head wounds while on anticoagulation. While it might seem intuitive that a patient on anticoagulation would be more susceptible to hemorrhage, this study actually quantifies the level of morbidity and mortality associated with subdural hematomas caused by ground level falls in patients who are anticoagulated.
Berry JAD, Mohamadi P, Davis JV, Miulli DE, Dong F. Differences in Morbidity & Mortality from Traumatic Subdural Hematoma due to Ground Level Falls While on Anticoagulation. Clin Surg. 2016; 1: 1189.