Epidural Hematoma (EDH) in Low- and Middle-Income Countries (LMICs): A Systematic Review of the Literature
DOI:
https://doi.org/10.63969/qqf1pq35Keywords:
Epidural hematoma, Traumatic brain Injury, global neurosurgeryAbstract
Epidural hematoma (EDH) is a neurosurgical emergency associated with a high mortality rate. This study aimed to describe the incidence, management, and clinical outcomes of EDH in low- and middle-income countries (LMICs) and low-income countries (LICs).
Methods: A systematic review of the literature was conducted using PubMed, Scopus, and ScienceDirect. Observational studies reporting incidence, operative rates, and mortality in patients >15 years with EDH were included.
Results: Nineteen studies comprising 4,481 patients were included; 66.7% were male, predominantly young adults. The overall incidence of EDH was 8.1%, with no significant difference between LMICs and LICs (p = 0.42). Operative rates were significantly lower in LICs (42%; p = 0.003**). Non-operative mortality reached 89.1% in LICs (p = 0.006*). The certainty of evidence was rated as low due to methodological heterogeneity and risk of bias across studies.
Conclusions: Clinical outcomes of EDH are strongly influenced by timely access to surgical intervention and neuroimaging-based diagnosis. Strengthening neurosurgical systems and emergency care capacity in resource-limited settings is essential to reduce preventable deaths in LMICs and LICs.
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Copyright (c) 2025 Angelo Israel Garcia Purcachi , Genesis Elena Franco Aguayo, Denisse Katherine Pinzon Moran, Jimmy Fernando Yaguana Torres, Christian David Cevallos Mendoza, Israel Rollin Guerrero Ulloa (Autor/a)
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