Predictive Parameters in Decision-Making for Surgical Intervention and Patients' Prognosis in Isolated Intracranial Epidural Hematoma

Objective: This study aimed to predict surgical intervention decision and early prognosis in patients with isolated intracranial epidural hematoma (EDH) using clinical, laboratory, and radiological parameters obtained at admission to the hospital. Materials and Methods: Eighty-three patients with EDH due to "fall from a height" or "traffic accident" were examined. For each patient, age, gender, Glasgow Coma Scale (GCS) scores on admission to the hospital, anisocoria, duration of stay in the intensive care unit and the hospital, and Glasgow Outcome Scale scores were recorded. Brain CT images obtained on admission to the hospital were examined, and the hematoma thickness and midline shift values were measured. Additionally, patients' blood biochemistry results were recorded. Results: ROC curve analysis revealed that hematoma thickness, midline shift, basophil count, and serum potassium level were predictive parameters for surgical intervention in pediatric patients. In addition, preoperative hematoma thickness and midline shift, serum sodium, potassium, ALT, and CRP values could predict the decision to perform surgical intervention in adult patients. Finally, GCS scores and serum sodium values could predict patients' early outcomes. Conclusion: The study results suggested that hematoma thickness, midline shift values, and some blood biochemistry parameters could be used as predictive markers in the decision-making for surgical intervention in patients with isolated EDH. Additionally, the GCS score determined at admission to the hospital could be used as a predictive marker of patients’ early prognosis.