Traumatic EDH: Trends in National Mortality and Cost, 1993-2006

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Epidural hematoma is a well-known sequela of traumatic brain injury, although information regarding patient outcomes and cost previously has been derived mainly from single-institution series. The aim of our study was to evaluate these data for trends on a national level. We evaluated 28,158 traumatic epidural hematoma admissions recorded in the National Inpatient Sample database over the 14-year period from 1993 to 2006 for mortality, cost, length of stay, and discharge status. Admissions for traumatic epidural hematoma increased 19.4 percent from 1,849 in 1993 to 2,207 in 2006, an increase that corresponds to population growth. Incidence during this period was stable at 7 per 1 million. In-hospital mortality varied from 2.5 percent to 6 percent, and rates of routine discharge remained between 70 percent and 75 percent. Despite a decrease in length of stay from 9.3 days to 5.9 days, average hospital charges increased 69 percent, from $26,030 to $44,046. This increase in percentage corresponded to an increase in average hospital charges by approximately $1,300 per admission per year. This study provides a national perspective on inpatient trends for traumatic epidural hematoma. The data show that, while incidence of and mortality from traumatic epidural hematoma remained stable, lengths of stay decreased and hospital charges increased significantly over this time period.