Highlight
– A comparative effectiveness study assessed outcomes of acute surgical evacuation versus initial conservative treatment for acute subdural hematoma (ASDH) in trauma patients.
– Among 711 patients with ASDH, 21% underwent acute surgery, predominantly decompressive craniectomy, while 79% received conservative treatment.
– There was significant variability in surgical intervention rates between trauma centers with similar patient prognoses.
– No meaningful difference in 6-month functional outcomes was observed between centers favoring surgery versus conservative management, suggesting conservative treatment could be a viable option when clinical equipoise exists.
