Functional outcomes and mortality in patients with acute traumatic subdural hematoma

Introduction. Acute subdural hematoma remains one of the most severe forms of traumatic brain injury, characterized by a high risk of adverse outcomes. Despite a significant number of studies, information on the clinical outcomes of treatment, the frequency of medical complications, and the functional recovery of patients remains limited. According to previously published studies, the mortality rate in this pathology varies from 22 to 66 %. Materials and methods. A retrospective cohort study was conducted based on the analysis of a prospectively generated database of patients treated between 2020 and 2025. All patients were divided into groups depending on the surgical hematoma evacuation. At the same time, it was assumed that the need for surgical intervention reflected the more severe nature of the traumatic injury. Results. The study included 1,427 patients with an average age of 58 years. Men prevailed among the surveyed — 63 %. Upon admission, the Glasgow Coma Scale score exceeded 12 points in 58 % of patients. The average value of the injury severity index (ISS) was 27.5 points. The average length of stay in the intensive care unit reached 9.6 days (from 1 to 110 days), while 40 % of patients were in the intensive care unit for at least two days. Various medical complications were reported in 28 % of patients. By the time of discharge, 94 % of patients had a score on the Glasgow Coma scale of 13 points or higher. Independence in performing basic daily functions, including facial expressions, independent eating and movement, was noted in 92 %, 81 % and 43 % of patients, respectively. The overall hospital mortality rate was 16 % and did not significantly differ statistically between patients who underwent surgical hematoma evacuation (15 %) and patients who received conservative treatment (17 %). Conclusion. An analysis of the treatment results of a large cohort of patients with acute traumatic subdural hematoma showed a lower hospital mortality rate compared with previously published data. This trend continued among patients who underwent surgical removal of a hematoma.