Factors influencing hematoma expansion in delayed brain CT scans of patients with traumatic Epidural Hematoma.

Background: Epidural hematoma (EDH) is a type of intracranial hematoma commonly observed in trauma patients. This research aims to evaluate the factors contributing to the expansion of traumatic epidural hematoma (EDH).

Methods: This retrospective cohort study examined traumatic patients with EDH admitted to Taleqani Hospital, a prominent Western Trauma Center in Iran, from 2018 to 2023. Patients underwent an initial CT scan, and non-surgical patients received a delayed CT scan approximately 5 hours after the initial scan. Data analysis was performed using SPSS version 25 software.

Results: The study included 274 brain trauma patients with epidural hematoma. Among these patients, 142 (51.8%) did not undergo surgery, and 121 (85.2%) of the non-surgical patients were male. Motor vehicle accidents (MVAs) were the primary cause of EDH in 127 (46.4%) patients. The mean (±standard deviation) initial hematoma size was 8.86 (±9.71), and the mean (±standard deviation) delayed CT scan size was 8.12 (±8.10). In crude linear regression Two variables, namely Hematoma volume in the initial CT scan (P less than 0.001) and Mixed Density (P=0.007), were found to significantly impact the increase in hematoma size in delayed CT scans of non-surgical patients. But in the adjusted linear regression model, only the Hematoma volume in primary CT scan, was significant (P less 0.001). The R Square values were 0.72.

Conclusions: The identification of key variables influencing hematoma volume in delayed CT scans has the potential to guide more effective interventions, thereby improving patient outcomes and reducing trauma-related mortality.