Table 1

Summary of included studies of ASDH in elderly following systematic review of the literature

Author, yearLocation (period)CountryNo of hospitals/
Age for inclusion (years)Age (years)
% Male
TreatmentOutcomes measuredRisk factor analysisSTROBE criteriaROBINS-I score
Wilberger et al, 199120Allegheny General Hospital (1982 to 1987)USA1/28>65N/ACraniotomyMortality, GOS at dischargeAge, ICP, GCS, timing of surgery; descriptive analyses (not in elderly group alone)17Moderate
Cagetti et al, 199221University of Genoa Medical School (January 1980 to December 1988)Italy1/26>8084.2 (mean)
Surgical evacuationMortality, GOS at dischargeAge, mechanism, GCS, comorbidities; descriptive analyses (not in elderly group alone)10Serious
Jamjoom, 199222Frenchay Hospital (1980 to 1989)UK1/27≥7579.2 (mean)
Surgical evacuationMortality, GOS at 6 monthsAge, sex, mechanism, GCS/ pupils, imaging, timing of surgery; χ2 test14Moderate
Kotwica and Jakubowski, 199223Medical University of Lodz (1984 to 1990)Poland1/27>70N/ASurgical evacuationMortality, GOS at dischargeAge, gender, GCS, imaging; descriptive analyses15Moderate
Massaro et al, 199624Centro Traumatologico Ortopedico (1982 to 1992)Italy1/25>65N/ADCMortality, GOS at 18 monthsAge, gender, mechanism, GCS, timing of surgery, imaging; χ2 test/ Fisher’s exact test (not in elderly group alone)15Moderate
Koc et al, 199725Erciyes University (January 1986 to August 1995)Turkey1/15≥61N/ACraniotomyMortality, GOS at 3 monthsAge, gender, presenting GCS; χ2 test (not in elderly group alone)10Moderate
Petridis et al, 200926UKSH Campus KielGermany1/119>65N/A
Craniotomy, DCMortality, GOS dischargeGCS/ pupils, imaging, anticoagulation, ICP; χ2 test, ANOVA13Moderate
Hanif et al, 200927Beaumont Hospital (January 1999 to December 2003)Ireland1/29>7077.0 (mean)
Surgical evacuationMortality, GOS at 6 monthsAge, GCS; descriptive analyses (not in elderly group alone)13Moderate
Taussky et al, 201228Kontansspital Aarau (January 2002 to December 2007)Switzerland1/37>6573.0 (median)
Craniotomy - 23
DC - 14
Mortality at discharge
Mortality, GOS at 6 months
Age, pupils, timing of surgery, GCS/ pupils, anticoagulants, comorbidities; descriptive analyses20Moderate
Hamed et al, 201640Rheinische Friedrich-Wilhelms University (January 2010 to December 2014)Germany1/57>70N/ACraniotomy, DCGOS at 6 monthsAge, TBI severity, timing of admission, surgical approach, antithrombotics, timing of surgery, duration of hospital stay, postoperative complications (not for elderly group alone)17Serious
Merzo et al, 201629Uppsala University Hospital (2008 to 2010)Sweden1/24≥65N/ACraniotomy – 23
DC – 1
Mortality, GOS at 6 monthsAge, gender, comorbidities, mechanism, imaging; χ2, unpaired Student’s t-test (not for elderly group alone)17Moderate
Raj et al, 201630Helsinki University Hospital (January 2009 to December 2012)Finland1/44≥7581.0 (median)
Craniotomy, DCMortality at 1 and 3 yearsAge, baseline functional status, residence, gender, anticoagulants, mechanism, GCS/ pupils; χ2 test, unpaired Student’s t-test, Mann-Whitney U test18Moderate
Benedetto et al, 201731Azienda Ospedaliero-Universitaria Pisana (June 2011 to December 2014)Italy1/67>7080.5 (median)
CraniotomyMortality, GOS at 1 and 6 monthsAge, imaging, GCS, antiplatelets; simple and multiple linear regression17Moderate
McGinity et al, 201732University of Texas Health Science Center (2005–2015)USA1/34≥8084.0 (mean)
Craniotomy – 32
DC – 2
Mortality, GOS at 2 months (variable)Age, mechanism, type of surgery, anticoagulants, GCS/ pupils, imaging, comorbidities; Fisher’s exact test, Mann-Whitney U test17Moderate
Won et al, 201733Goethe-University Hospital (January 2007 to December 2016)Germany1/56≥8085.0 (mean)
Craniotomy, DCMortality at dischargeGCS; univariate/multivariate logistic regression20Moderate
Monsivais et al, 201834University of Texas Health Science Centre (January 2006 to July 2016)USA1/112≥70N/ACraniotomy – 101
DC – 11
Mortality at dischargeAge, GCS, type of surgery; χ2 test/ Fisher’s exact test20Moderate
Akbik et al, 201935University of New Mexico Hospital (January 2013 to December 2017)USA1/62≥6578.0 (median)
Craniotomy, DCMortality, GOS at discharge and 3 monthsAge, comorbidities, GCS/pupils, imaging, antithrombotics; Kruskal-Wallis, Fisher’s exact test15Moderate
Bus et al, 201936Academic Medical Centre (January 2000 to October 2015)Netherlands1/84≥6575.0 (mean)
Craniotomy – 74
DC – 10
Mortality at discharge
Mortality, GOS at 1 year
Age, gender, imaging, GCS/ pupils, age of SDH, imaging, timing of surgery, anticoagulation; χ2/ Fisher’s exact tests, Mann-Whitney U test, univariate logistic regression17Moderate
Sufaro et al, 201937Soroka University Medical Center (2006–2016)Israel1/28>7081.5 (mean)
CraniotomyMortality, mRS score at discharge and 1 yearAge, gender, baseline status, antithrombotics, GCS, imaging, neurological deficit; descriptive analyses17Serious
Trevisi et al, 202038Ospedale Santo Spirito; Fondazione Policlinico Universitario A. Gemelli IRCSS; S. Anna University Hospital, UOC Neurochirurgia (January 2016 to December 2019)Italy5/147≥7078 (mean)
Craniotomy- 133
DC- 14
Mortality, GOS at discharge and 6 monthsAge, gender, comorbidities, GCS/pupils, imaging, side of SDH, size of craniotomy, timing of surgery, anticoagulants; χ2 test, univariate/multivariate logistic regression16Moderate
Younsi et al, 202039University Hospital Heidelburg (January 2006 to December 2016)Germany1/27≥8084.0 (median)
Craniotomy, DCMortality, GOS at dischargeAge, gender, comorbidities, GCS/pupils, imaging, surgical factors, anticoagulants; Fisher’s exact test, unpaired Student’s t-test21Serious
  • ANOVA, analysis of variance; ASDH, acute subdural haematoma; DC, decompressive craniectomy; GCS, Glasgow Coma Score; GOS, Glasgow Outcome Scale; ICP, intracranial pressure; IRCSS, Istituto di Ricovero e Cura a Carattere Scientifico; mRS, modified Rankin Scale; N/A, not available; ROBINS-I, risk of bias in non-randomised studies of interventions; SDH, subdural haematoma; STROBE, Strengthening of Reporting of Observational Studies in Epidemiology; TBI, traumatic brain injury; UKSH, Universitätsklinikum Schleswig-Holstein; UOC, Unità Operativa Complessa.