Epidemiology

The exact incidence of subdural hematoma (SDH) is unknown. Acute SDH is found in about 11% to 20% of patients admitted to hospital with mild to severe traumatic brain injury.[4] The annual incidence of patients with closed head injury admitted to hospitals in the US is estimated at 200 per 100,000 people.[5] Overall, SDHs account for 50% to 60% of acute traumatic intracranial hematomas, and they are more likely to occur after falls or assaults than after motor vehicle accidents.[1][6][7]​​​ They can also occur with increased frequency in patients with coagulopathy (iatrogenic or pathologic).[1][8][9]​​​ Vitamin K antagonists increase the risk of SDH approximately threefold over the risk associated with factor Xa or antiplatelet agents and approximately twofold over the risk associated with direct thrombin inhibitors.[10]

It is predicted that the incidence rates of chronic SDH in aging populations in the US Veterans Administration and civilian populations will reach 121.4 and 17.4 cases per 100,000 people, respectively, by 2030.[11]​ Incidence estimates of chronic SDH in the UK range from 1.7 per 100,000 per year to 48 per 100,000 per year.[12]​ Several longitudinal studies have demonstrated increased incidence over time, likely driven by aging populations, increased detection linked to access to imaging, and use of anticoagulation.[12]​ Chronic SDHs occur most commonly in older people (age >65 years), and are frequently associated with a history of falls or anticoagulant use.[13][14]

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