Extra-axial hematomas due to road traffic accidents and their outcome: a ten-year study

The main objectives of this study were to describe the epidemiological characteristics, the associated factors and outcomes of extra-axial hematoma (EAH) in patients of traumatic brain injury (TBI) due to road traffic accident (RTA) and to assess their survival probability after 6 and 12 months to RTA.

This was a retrospective record-based study. A total of 520 patients diagnosed with EAH due to RTA-related TBI were studied. This study covered ten years from January 1, 2010, to December 31, 2019. Descriptive statistics, including frequencies, percentages, mean, standard deviation, median and range were used. To test for significance in the difference between proportions, a chi-square test was applied and adjusted standardized residual to confirm the differences between groups. The Kaplan-Meier curve was plotted, and mean survival rates were calculated for each type of EAH. A two-sided p-value less than 0.05 (5%) at 95% CI was considered to be statistically significant.

EAH occurred in 42.1% of RTA-related TBI. Subdural hematoma (SDH) was the most common RTA-related EAH. Age and sex differences exist in the type of EAH with male preponderance and a significantly higher rate of SDH in patients aged 55 years or above. The total EHA mortality was 18.7%, and most occurred within the first month of the incident. Traumatic subarachnoid hemorrhage (tSAH) was associated with poorer outcome in terms of mortality. Epidural hematoma (EDH) has the best prognosis and survival probability at six months and one year from the accident.

Extra-axial hematomas are very common in RTA-related TBIs and have high mortality. SDH is the most common, tSAH had the highest mortality, while EDH has the best survival. Aggressive efforts are compulsory to reduce RTA-related TBI.