Age-Related Predictors of Outcomes for Subdural Haematoma

Abstract Background Subdural haematoma (SDH) is a potentially life-threatening form of traumatic brain injury, occurring in both younger and older adults. This study aimed to identify which clinical and radiological severity markers best predict patient outcomes and whether these predictors differ by age group. Methods A retrospective review was conducted on SDH-related admissions to the National Trauma Centre between July 2023 and September 2024. Radiological severity was assessed using maximum SDH depth and midline shift, while clinical severity was measured via the Glasgow Coma Scale (GCS). Outcome measures included hospital length of stay and 30-day all-cause mortality. Statistical analysis was performed using Minitab. Results Isolated SDH accounted for 38.9% of all traumatic brain injuries admitted during the study period (n=203). The mean age was 68.4 ±18.7 years; 59.5% were aged ≥65 years and 67% were male. Mean SDH depth was 8.5 ±7.3 mm; midline shift, 1.62 ±3.9 mm; and GCS, 14 ±2.2. Across all ages, SDH depth demonstrated a moderate correlation (r = 0.343, p = 0.015) with length of stay, while GCS and midline shift showed a weak correlation with length of stay (r = -0.257, p = 0.039, r = 0.288, p = 0.87, respectively). In older adults, GCS had a stronger, and significant, correlation with length of stay (r = -0.428, p < 0.001), while in younger adults, SDH depth and midline shift were more strongly associated with length of stay (r = 0.572, p = 0.070; r = 0.493, p = 0.78, respectively). Thirty-day mortality was 2.08% in older and 6.35% in younger patients, with no significant difference or correlation to predictors. Conclusion Clinical and radiological predictors of outcome in SDH vary by age. GCS is a stronger prognostic indicator in older adults, whereas radiological markers have greater predictive value in younger patients.