mersin univ saglık bilim derg Mersin Üniversitesi Sağlık Bilimleri Dergisi 1308-0830 Mersin University 10.26559/mersinsbd.594262 Health Care Administration Sağlık Kurumları Yönetimi The factors affecting the prognosis of surgically treated acute epidural hematoma patients: The retrospective analysis of 89 cases Cerrahi olarak tedavi edilen akut epidural hematomlu hastalarda prognoz üzerine etki eden faktörler: Seksendokuz hastanın retrospektif analizi https://orcid.org/0000-0002-8234-8013 Özalp Hakan MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0002-8404-7484 Esen Kaan MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0003-4681-4061 Avcı Emel MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0001-6786-4477 Akbıyık Tolga MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0001-6796-518X Koyuncu Ömer Ruşen MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0002-4237-9288 Bağdatoğlu Celal MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0001-7368-6937 Dağtekin Ahmet MERSİN ÜNİVERSİTESİ https://orcid.org/0000-0003-0249-7711 Hamzaoğlu Vural 12 31 2019 12 3 378 387 07 19 2019 09 18 2019 Copyright © 2008, Mersin Üniversitesi Sağlık Bilimleri Dergisi 2008 Mersin Üniversitesi Sağlık Bilimleri Dergisi

Aim: The mostcommon cause of acute epidural hematoma (AEH) is parietotemporal bone fracturesdue to injury of the arteria meningea media. In this study, we aimed toinvestigate the factors affecting prognosis in patients operated with thediagnosis of acute epidural hematoma in our clinic. Methods: Between 2007 and2018, eighty-nine patients who were diagnosed as AEH in the Department ofNeurosurgery, Faculty of Medicine, Mersin University were included in thestudy. Patients were divided into groups according to the age, initial Glasgowcoma scale (GCS), neurological findings, location, extent and operation of AEH.The findings were compared according to mortality, morbidity, intensive careand discharge period. Results: Seventy-five of the patients weremale, 14 were female and the mean age was 25.7 years. The most commonlocalization of the hematoma was parietotemporal region in 31 (34.8%)patients.The hematoma was evacuated by craniotomy in 59 (66.3%) patients whilecraniectomy was done in 30 (33%) patients for treatment. The worst clinicaloutcomes were found in patients with GCS 8 and below after arrival. Thecomplications (44;0%) and mortality rates (52,0%) were found to be high in thosepatients and the mean hospitilization period was found as 18.3 days. Conclusion: Early diagnosis andtreatment, the presence of high GCS, age less than 18 years and hematomathickness less than 20 mm were found to be associated with good prognosis,while temporal location of the hematoma was predicted to be associated withpoor prognosis.

Amaç: Akut epidural hematom(AEH) kafa travması sonrası sıklıklatemporoparietal kemik kırıkları nedeni ile arteria meningea medianınyaralanması sonucu görülmektedir. Bu çalışmada, kliğimizde akut epiduralhematom tanısı konularak opere edilen hastalarda, prognozu etkileyenfaktörlerin araştırılması amaçlanmıştır. Yöntem: Çalışmaya, 2007-2018yılları arasında Mersin Üniversitesi Tıp Fakültesi Beyin ve Sinir CerrahisiAnabilim Dalı’nda AEH tanısı alarak cerrahi yöntemle tedavi edilen 89 hastadahil edilmiştir. Hastalar yaşgrupları, geliş Glasgow koma skalası (GKS), nörolojik bulguları, AEH’nin yeri,genişliği ve yapılan operasyon şekline göre gruplara ayrılmıştır. Hastalardamortalite, morbidite, yoğun bakım ve hastane kalış sürelerine göre prognozkriterleri belirlenmeye çalışılmıştır. Bulgular:Hastaların 75’i erkek, 14’ü kadın olup, ortalama yaş 25.7 olarak tespitedildi. Hastalarda görülen en sık başvuru bulgusu şuur değişikliği idi (%66.9).Hematomun en sık görüldüğü lokalizasyon 31 (%34.8) hastada parietotemporalbölge olarak saptandı. Ellidokuz (%66.3) hastada kraniyotomi ile hematomboşaltılırken, 30 (%33.0) hastadakraniektomi ile hematom boşaltıldı. En kötü klinik sonuçlar geliş GKS’si 8 vealtında olan hastalarda tespit edilmiştir. Bu hastalarda komplikasyon (%44.0),mortalite (%52.0) oranı oldukça yüksek ve hastanede yatış sürelerinin (ortalama18.3 gün) uzun olduğu saptanmıştır. Hematom kalınlığı 20 mm üzerinde olanhastalarda komplikasyon ve mortalite oranı yüksek bulunmuştur. Sonuç: AEH’de erken tanı ve tedavininyanısıra geliş GKS’sinin yüksek olması, hastanın yaşının 18’den daha küçükolması ve hematom kalınlığının 20 mm’den küçük olması iyi prognozla ilişkiliolarak tespit edilmişken, hematomun temporal bölgede yer almasının kötüprognozla ilişkili olabileceği öngörülmüştür.

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