Pustaka Ilmiah Universitas Padjadjaran

Abstrak

The Craniectomy Procedure Decreased Mortality Rate In Traumatic Acute Subdural Hematoma (TASDH)

The mortality rate after traumatic acute subdural hematoma (TASDH) is around 50 – 90%. There are many factors that affect the management of TASDH. Operative measures include decompressive craniectomy or craniotomy evacuation. This research compares both of these operative techniques in TASDH. This research is an observational analysis with cross sectional design. Data was compiled retrospectively through patient medical records since January 2006 – December 2009 in Neurosurgery Department Hasan Sadikin Hospital Bandung. Statistical analysis was applied using chi square test, multiple regression logistic analysis and Pearson chi square test. Significance of test results will be determined based on the value of p <0.05. There were 148 ATSDH operations consisting of 117 males and 31 females with age range of 1 – 75 years (x; 33,7 ; SB=16,5). Eighty four patients underwent craniotomy while 64 under went craniectomy. Mortality rate corresponded significantly with age (p<0,01), GCS (p<0,01), neurological deficit (p<0,01), compressed cisterns (p<0,01), and also midline shift (p=0,047). There was no significant relationship between mortality rate and sex (p=0,168), and also with operation interval (p=0,127). From our research we found 110 patient with compressed cisterns, in which 55 patients underwent craniotomy with death in 42 of them (76%), whereas 55 patients underwent craniectomy in which there were 19 death (34%). Craniectomy relates significantly (p<0,01) in lowering mortality rate in ATSDH with compressed cisterns. The craniectomy procedure decreased mortality rate in traumatic acute subdural hematoma , with an odd's ratio of 1.71 higher in patients undergoing craniotomy compared with craniectomy.