Increasing traumatic brain injury (TBI) has paralleled the need for decompression surgery for acute subdural (ASDH) and acute extradural haematoma (AEDH). Knowledge of key determinants of clinical outcomes of such patients is mandatory to guide treatment protocols. To determine the 30-day clinical outcomes and predictor variables for patients with extra-axial hematomas at Mulago National Referral Hospital in Uganda. Prospective observational cohort study of 109 patients with computed tomography (CT) confirmed extra-axial hematomas. Ethical clearance was obtained from the School of Medicine Research and Ethics Committee of College of Health Sciences, Makerere University (REC REF. 2018-185). Admitted patients were followed-up and reassessed for Glasgow Outcome Scale (GOS) and final disposition. Multivariate regression analysis was performed using Stata 14.0 (StataCorp. 2015) at 95% confidence interval, regarding p < 0.05 as statistically significant. The overall proportion of favorable outcome was 71.7% (n = 71), with 42.3% (n = 11) and 81.7% (n = 58) for ASDH and AEDH, respectively (p = 0.111). Factors associated with a favorable outcome were admission systolic BP > 90 mmHg [IRR = 0.88 (0.26–0.94) 95%CI, p = 0.032), oxygen saturation > 90% [IRR = 0.5 (0.26–0.94) 95%CI, p = 0.030] and diagnosis AEDH [IRR = 0.53 (0.30–0.92) 95%CI, p = 0.025). Moderate TBI [IRR = 4.57 (1.15–18.06) 95%CI, p = 0.03] and severe TBI [IRR = 6.79 (2.32–19.86) 95%CI, p < 0.001] were significantly associated with unfavorable outcomes. The study revealed that post resuscitation GCS, systolic BP, oxygen circulation, and diagnosis of AEDH at admission are the most important determinants of outcome for patients with extra-axial intracranial hematomas. These findings are valuable for the triaging teams in resource-constrained settings.

中文翻译：

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急性硬脑膜外和硬膜下血肿的颅脑外伤患者的30天临床结局：乌干达穆拉戈国家转诊医院的一项队列研究

越来越多的创伤性脑损伤（TBI）与对急性硬膜下（ASDH）和急性硬膜外血肿（AEDH）进行减压手术的需求并行。必须了解这类患者临床结果的关键决定因素，才能指导治疗方案。为了确定乌干达穆拉戈国家转诊医院的轴外血肿患者的30天临床结果和预测变量。109例计算机断层扫描（CT）患者的前瞻性观察队列研究证实了轴外血肿。道德许可已从马克雷雷大学（Makerere University）卫生科学学院医学研究与伦理委员会获得（REC REF.2018-185）。对入院的患者进行随访并重新评估格拉斯哥预后量表（GOS）和最终处置。使用Stata 14.0（StataCorp.2015）在95％置信区间进行多变量回归分析，认为p <0.05为有统计学意义。有利结果的总体比例为71.7％（n = 71），其中ASDH和AEDH分别为42.3％（n = 11）和81.7％（n = 58）（p = 0.111）。与预后良好相关的因素是收缩期血压> 90 mmHg [IRR = 0.88（0.26-0.94）95％CI，p = 0.032），氧饱和度> 90％[IRR = 0.5（0.26-0.94）95％CI，p = 0.030]和诊断AEDH [IRR = 0.53（0.30–0.92）95％CI，p = 0.025）。中度TBI [IRR = 4.57（1.15–18.06）95％CI，p = 0.03]和重度TBI [IRR = 6.79（2.32–19.86）95％CI，p <0.001]与不良结局显着相关。研究表明，复苏后GCS，收缩压，氧气循环，入院时AEDH的诊断和诊断是轴外颅内血肿患者预后的最重要决定因素。这些发现对于在资源有限的环境中的分诊团队而言是有价值的。