Dataset Information

Surgical evacuation for chronic subdural hematoma: Predictors of reoperation and functional outcomes.

ABSTRACT:

Background

Although chronic subdural hematoma (CSDH) incidence has increased, there is limited evidence to guide patient management after surgical evacuation.

Objective

To identify predictors of reoperation and functional outcome after CSDH surgical evacuation.

Methods

We identified all patients with CSDH between 2010 and 2018. Clinical and radiographic variables were collected from the medical records. Outcomes included reoperation within 90 days and poor (3-6) modified Rankin Scale score at 3 months.

Results

We identified 461 surgically treated CSDH cases (396 patients). The mean age was 70.1 years, 29.7 % were females, 298 (64.6 %) underwent burr hole evacuation, 152 (33.0 %) craniotomy, and 11 (2.4 %) craniectomy. Reoperation rate within 90 days was 12.6 %, whereas 24.2 % of cases had a poor functional status at 3 months. Only female sex was associated with reoperation within 90 days (OR = 2.09, 95 % CI: 1.17-3.75, P = 0.013). AMS on admission (OR = 5.19, 95 % CI: 2.15-12.52, P < 0.001) and female sex (OR = 3.90, 95 % CI: 1.57-9.70, P = 0.003) were independent predictors of poor functional outcome at 3 months.

Conclusion

Careful management of patients with the above predictive factors may reduce CSDH reoperation and improve long-term functional outcomes. However, larger randomized studies are necessary to assess long-term prognosis after surgical evacuation.

SUBMITTER: Sioutas GS

PROVIDER: S-EPMC10694339 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

Surgical evacuation for chronic subdural hematoma: Predictors of reoperation and functional outcomes.

Sioutas Georgios S GS Sweid Ahmad A Chen Ching-Jen CJ Becerril-Gaitan Andrea A Al Saiegh Fadi F El Naamani Kareem K Abbas Rawad R Amllay Abdelaziz A Birkenstock Lyena L Cain Rachel E RE Ruiz Ramon L RL Buxbaum Michael M Nauheim David O DO Renslo Bryan B Bassig Jonathan J Gooch M Reid MR Herial Nabeel A NA Jabbour Pascal P Rosenwasser Robert H RH Tjoumakaris Stavropoula I SI

World neurosurgery: X 20231108

<h4>Background</h4>Although chronic subdural hematoma (CSDH) incidence has increased, there is limited evidence to guide patient management after surgical evacuation.<h4>Objective</h4>To identify predictors of reoperation and functional outcome after CSDH surgical evacuation.<h4>Methods</h4>We identified all patients with CSDH between 2010 and 2018. Clinical and radiographic variables were collected from the medical records. Outcomes included reoperation within 90 days and poor (3-6) modified Ra ...[more]

PMID: 38054079

Similar Datasets

Project description:ObjectiveThis study systematically reviews the clinical efficacy and safety of twist-drill craniostomy with hollow screws in chronic subdural hematoma treatment.MethodsA computerized search of PubMed, Embase, Web of Science, Cochrane Library, World Health Organization International Trial Registry platform, CBM, CNKI, and Wanfang Database was performed to retrieve randomized controlled trials or case-control trials using twist-drill craniostomy (TDC) with hollow screws for the evacuation of chronic subdural hematoma from the date of databases' inception to July 2021. Two investigators independently screened the studies and extracted data in strict accordance with pre-established inclusion and exclusion criteria. RevMan 5.3 software or STATA was used for meta-analysis after evaluating the methodological quality of the included studies.ResultsA total of 4 randomized controlled trials and 16 case-control trials with a total of 2,536 cases were included. Results of the meta-analysis showed that the surgical success rate and postoperative recurrence rate of TDC with hollow screws were slightly higher compared to the burr hole craniostomy (BHC) group, but showed no statistical significance (RR = 1.03, P = 0.05; RR = 1.13, P = 0.50). However, subgroup analysis showed that the use of YL-1 needle had a higher success rate and lower recurrence rate (RR = 1.05, P = 0.02 < 0.05; RR = 0.584, P = 0.002), and TDC with hollow screws had a lower incidence rate of postoperative complications and postoperative acute intracranial hemorrhage compared with BHC, also revealing an overall shorter hospital stay (RR = 0.57, P = 0.0002 < 0.05; RR = 0.584, P = 0.027 < 0.05; WMD = -3.752, P < 0.001). However, the postoperative mortality rate was practically the same between the two groups (OR = 1.01, P = 0.95 > 0.05).ConclusionTwist-drill craniostomy with hollow screws is not inferior or superior to BHC in efficacy, and this strategy is safer and minimally invasive, which is reflected in a lower incidence of acute intracranial hemorrhage, overall complication rate, and length of hospital stay.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021270835.

Dataset Information

Surgical evacuation for chronic subdural hematoma: Predictors of reoperation and functional outcomes.

Background

Objective

Methods

Results

Conclusion

Publications

Surgical evacuation for chronic subdural hematoma: Predictors of reoperation and functional outcomes.

Similar Datasets

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