Factors Influencing Outcome of Simple Depressed Fracture of Skull

Abstract

The primary aim of our study is to identify the factors affecting the outcomes in cases of simple depressed skull fracture. This will help us improve outcomes and give a more accurate prediction of long-term outcomes. This is a retrospective study. We included 161 patients who were diagnosed with simple depressed skull fractures (DSFs) and underwent surgery at our hospital. Patients with comorbidity involving injury to other organs or medical disorders were excluded. We used the chi-square test and Fisher exact test. There was a statistically significant impact on age, sex, Glasgow Coma Scale (GCS) score at presentation, type of DSF, and site of DSF on the long-term outcome of patients. Patients with a GCS score of 13 or more fared well with a good long-term outcome, as opposed to those with a GCS score below it. Any additional brain injury in the form of hematomas has a significant negative impact on the long-term outcome of the patient. Complications such as cerebral contusions, pneumocephalus, and seizures have an adverse effect on the recovery. Our observations suggest that patients brought to the hospital with minimal delay, with a GCS score between 13 and 15, with a simple DSF and normal brain parenchyma without dural tear have the best outcome. Other brain injuries such as epidural hematoma, acute subdural hematoma, contusion, and traumatic SAK, along with depressed fracture, increase morbidity and cause prolonged or poor outcomes. Demographic factors do not affect outcomes. Pneumocephalus, epileptic seizures  and dural tears with brain injuries have  adverse effect on the recovery of the patients.