Prognostic Significance of Hematological and Radiologic Parameters Patients with Traumatic Epidural Hematoma Subjected to Craniotomy

Abstract To analyze hematological and radiologic parameters to determine their prognostic utility postcraniotomy for traumatic epidural hematoma (EDH). The present observational study meticulously followed the clinical trajectories of patients diagnosed with traumatic EDH who underwent craniotomy intervention. The inclusion criteria were patients aged over 18 with confirmed traumatic EDH evident on computed tomography (CT) scan within 7 days of admission and possessing complete blood count data. We analyzed 64 patients postcraniotomy, stratified into 2 groups according to EDH thickness: ≤ 15 mm (n = 32) and > 15 mm (n = 32). Notably, patients with an EDH thickness exceeding 15 mm exhibited a heightened risk of 7-day postcraniotomy mortality associated with a decrease in red blood cell (RBC) count by 1 unit (odds ratio [OR]: 1.237; 95% confidence interval [CI]: 1.057–1.571; p = 0.038), a reduction in hemoglobin (Hb) by 1 unit (OR: 1.107; 95%CI: 1.023–1.388; p = 0.042), and a decrement in potassium (K) levels by 1 unit (OR: 1.572; 95%CI: 1.109–2.986; p = 0.027). Conversely, across patients regardless of EDH thickness, EDH volume, EDH midline shift (MLS), and EDH thickness demonstrated prognostic significance for mortality, as indicated by area under the curve (AUC) values exceeding 0.7. However, multivariate regression analysis revealed that only EDH MLS (OR: 3.558; 95%CI: 3.558–8.127; p = 0.027) and EDH thickness (OR: 3.862; 95%CI: 1.309–6.233; p = 0.035) reliably predicted 7-day mortality postcraniotomy. Decreased RBC, Hb, and K levels, along with increased EDH MLS and thickness on radiologic scans, portend an unfavorable 7-day postcraniotomy prognosis in patients with traumatic EDH.