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Observational Study
. 2022 Aug 1;22(1):287.
doi: 10.1186/s12883-022-02790-3.

A multicentre retrospective cohort study on health-related quality of life after traumatic acute subdural haematoma: does cranial laterality affect long-term recovery?

V D N Hoogslag #  1 , T A van Essen #  2 , M D Dijkman  2 , W Moudrous  3 , G G Schoonman  4 , W C Peul  2
Affiliations
Observational Study

A multicentre retrospective cohort study on health-related quality of life after traumatic acute subdural haematoma: does cranial laterality affect long-term recovery?

V D N Hoogslag et al. BMC Neurol. .

Abstract

Background: Traumatic acute subdural haematoma is a debilitating condition. Laterality intuitively influences management and outcome. However, in contrast to stroke, this research area is rarely studied. The aim is to investigate whether the hemisphere location of the ASDH influences patient outcome.

Methods: For this multicentre observational retrospective cohort study, patients were considered eligible when they were treated by a neurosurgeon for traumatic brain injury between 2008 and 2012, were > 16 years of age, had sustained brain injury with direct presentation to the emergency room and showed a hyperdense, crescent shaped lesion on the computed tomography scan. Patients were followed for a duration of 3-9 months post-trauma for functional outcome and 2-6 years for health-related quality of life. Main outcomes and measures included mortality, Glasgow Outcome Scale and the Quality of Life after Brain Injury score. The hypothesis was formulated after data collection.

Results: Of the 187 patients included, 90 had a left-sided ASDH and 97 had a right-sided haematoma. Both groups were comparable at baseline and with respect to the executed treatment. Furthermore, both groups showed no significant difference in mortality and Glasgow Outcome Scale score. Health-related quality of life, assessed 59 months (IQR 43-66) post-injury, was higher for patients with a right-sided haematoma (Quality of Life after Brain Injury score: 80 vs 61, P = 0.07).

Conclusions: This study suggests patients with a right-sided acute subdural haematoma have a better long-term health-related quality of life compared to patients with a left-sided acute subdural haematoma.

Keywords: ASDH; Acute subdural haematoma; Acute subdural hematoma; Health-related quality of life; Laterality; Qolibri; Quality of life.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patient flow chart
Fig. 2
Fig. 2
Functional outcome and Health-related Quality of Life. A Glasgow Outcome Scale. The Glasgow Outcome Scale (GOS) scores range from 1 (indicating dead) to 5 (Good recovery). Each cell in this graph corresponds with a GOS; the width of the cell indicates the proportion of patients with equivalent scores, and the numbers within the cell indicate the number of patients per category. B Health-related Quality of Life after Brain Injury score. The Quality of Life after Brain Injury score depicts the difference in health-related quality of life between left- and right sided ASDH patients. The Qolibri score is a score to indicate health-related quality of life after traumatic brain injury and is reported on a 0-100 scale (0 = worst possible health-related quality of life, 100 = best possible health-related quality of life). Each point represents a case in the respective groups. In both groups the median is represented by the numbers accompanying the points. Furthermore in this graph, both the highest and the lowest recorded Qolibri score is represented, with the highest score being 99 and the lowest score being 18
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