Jun Shen1, Lili Yuan2, Ruixiang Ge3, Qifu Wang4, Wei Zhou5, Xiao Chun Jiang6, Xuefei Shao7. 1. Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: shenyuanziyan@163.com. 2. Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: molly8338@126.com. 3. Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: geruixiang2013@163.com. 4. Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: wangqf881008@163.com. 5. Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: 18325353771@163.com. 6. Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: jiangxiaochun2001@hotmail.com. 7. Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, PR China. Electronic address: drshao@163.com.
Abstract
BACKGROUND: Chronic subdural hematoma (CSDH) is commonly encountered in the elderly patients and the recurrence rate is still high, therefore, identifying risk factors for CSDH recurrence is essential. The present study aimed to identify clinical and radiological factors predicting the recurrence of CSDH. METHODS: We retrospectively identified 461 patients with CSDH who underwent surgical evacuation in our department. Univariable analyses were performed at first, variables with a P-value of <0.05 were entered into multivariable logistic regression model. Kendall's tau-b test was used to evaluate the relationship between brain atrophy and postoperative pneumocephalus. RESULTS: Univariable analyses revealed that patients with the following characteristics have a higher recurrence rate, including age ≥80 years, antiplatelet and/or anticoagulant use, GOS = 3, the volume of drainage ≥100 ml, midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus. Multivariable logistic regression demonstrated that midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus, and volume of drainage ≥100 ml were independent risk factors for CSDH recurrence. Kendall's tau-b test revealed that there was no correlation between brain atrophy and postoperative pneumocephalus. CONCLUSIONS: Midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus, and volume of drainage ≥100 ml were independent risk factors for CSDH recurrence, CSDH patients with these characteristics should be taken precautions of recurrence and a closely follow-up should be carried out.
BACKGROUND:Chronic subdural hematoma (CSDH) is commonly encountered in the elderly patients and the recurrence rate is still high, therefore, identifying risk factors for CSDH recurrence is essential. The present study aimed to identify clinical and radiological factors predicting the recurrence of CSDH. METHODS: We retrospectively identified 461 patients with CSDH who underwent surgical evacuation in our department. Univariable analyses were performed at first, variables with a P-value of <0.05 were entered into multivariable logistic regression model. Kendall's tau-b test was used to evaluate the relationship between brain atrophy and postoperative pneumocephalus. RESULTS: Univariable analyses revealed that patients with the following characteristics have a higher recurrence rate, including age ≥80 years, antiplatelet and/or anticoagulant use, GOS = 3, the volume of drainage ≥100 ml, midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus. Multivariable logistic regression demonstrated that midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus, and volume of drainage ≥100 ml were independent risk factors for CSDH recurrence. Kendall's tau-b test revealed that there was no correlation between brain atrophy and postoperative pneumocephalus. CONCLUSIONS: Midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus, and volume of drainage ≥100 ml were independent risk factors for CSDH recurrence, CSDH patients with these characteristics should be taken precautions of recurrence and a closely follow-up should be carried out.
Authors: Sae Min Kwon; Min Ho Lee; Youngbeom Seo; Young Il Kim; Hyuk-Jin Oh; Kyung Hwan Kim; Kyu-Sun Choi; Kyuha Chong Journal: Korean J Neurotrauma Date: 2022-04-25
Authors: Giancarlo Mignucci-Jiménez; Alejandro J Matos-Cruz; Irakliy Abramov; Sahin Hanalioglu; Melissa S Kovacs; Mark C Preul; Caleb E Feliciano-Valls Journal: Surg Neurol Int Date: 2022-06-03
Authors: Ishita P Miah; Yeliz Tank; Frits R Rosendaal; Wilco C Peul; Ruben Dammers; Hester F Lingsma; Heleen M den Hertog; Korné Jellema; Niels A van der Gaag Journal: Neuroradiology Date: 2020-10-22 Impact factor: 2.804