Scandinavian Multicenter Acute Subdural Hematoma (SMASH) Study: Study Protocol for a Multinational Population-Based Consecutive Cohort

Jiri Bartek, Christian Laugesen, Sadia Mirza, Axel Forsse, Michael Anders Petersen, Alba Corell, Philip Wilhelm Dyhrfort, Henrietta Nittby Redebrandt, Linus Reen, Shaian Zolfaghari, Lovisa Tobieson, Björn Carlsvärd, Bo Bergholt, Asma Bashir, Preben Soerensen, Arzu Bilgin, Conny Johansson, Peter Lindvall, Petter Förander, Bo-Michael BellanderJacob B Springborg, Asgeir S Jakola

2 Citations (Scopus)


BACKGROUND: Traumatic acute subdural hematomas (ASDHs) are associated with high rate of morbidity and mortality, especially in elderly individuals. However, recent reports indicate that the morbidity and mortality rates might have improved.

OBJECTIVE: To evaluate postoperative (30-d) mortality in younger vs elderly (≥70 yr) patients with ASDH. Comparing younger and elderly patients, the secondary objectives are morbidity patterns of care and 6 mo outcome according to Glasgow outcome scale (GOS). Finally, in patients with traumatic ASDH, we aim to provide prognostic variables.

METHODS: This is a large-scale population-based Scandinavian study including all neurosurgical departments in Denmark and Sweden. All adult (≥18 yr) patients surgically treated between 2010 and 2014 for a traumatic ASDH in Denmark and Sweden will be included. Identification at is NCT03284190.

EXPECTED OUTCOMES: We expect to provide data on potential differences between younger vs elderly patients in terms of mortality and morbidity. We hypothesize that elderly patients selected for surgery have a similar pattern of care as compared with younger patients. We will provide functional outcome in terms of GOS at 6 mo in younger vs elderly patients undergoing ASDH evacuation. Finally, clinical useful prognostic factors for favorable (GOS 4-5) vs unfavorable (GOS 1-3) will be identified.

DISCUSSION: An improved understanding of the clinical outcome, treatment and resource allocation, clinical course, and the prognostic factors of traumatic ASDH will allow neurosurgeons to make better treatment decisions.

Original languageEnglish
Issue number3
Pages (from-to)799-803
Number of pages5
Publication statusPublished - 2019


  • Acute subdural hematoma
  • Elderly
  • Outcome
  • Predictors
  • Hematoma, Subdural, Acute/mortality
  • Prognosis
  • Humans
  • Middle Aged
  • Male
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Denmark/epidemiology
  • Adult
  • Female
  • Aged
  • Retrospective Studies
  • Research Design
  • Sweden/epidemiology
  • Cohort Studies


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