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Risk-assessment in chronic subdural hematoma evaluated in 148 patients - A score for predicting recurrence.

Abstract：

BACKGROUND:Chronic subdural hematoma (CSDH) is a frequent disease in neurosurgical practice. However, a considerable recurrence rate keeps this condition challenging to treat. We aimed to provide a simple tool for risk assessment in these patients. METHODS:We conducted a retrospective analysis of surgically treated patients with chronic subdural hematomas. In addition to patients' demographics, radiological assessment included volume, thickness, midline shift and density of hematomas. Statistically significant variables in univariate analysis were further analyzed in a multivariate logistic regression model to create a risk score for recurrence of CSDH. RESULTS:A total of 148 patients were identified and included for analysis. 50.7 % (n = 75) were older than 76 years of age. The overall hematoma recurrence rate requiring surgery was 23.6 % (n = 35). Preoperative thrombocytopenia, postoperative midline shift >6 mm, hematoma volume >80 mL and overall hematoma density >45 Hounsfield Units (HU), were significantly more frequent in the recurrence group. Furthermore, after multivariate assessment, postoperative hematoma density and volume were independent risk factors and included in the risk assessment tool. Patients were divided into 3 risk groups corresponding to the total scores. CONCLUSION:We provide a risk-score assessment for predicting recurrence of subdural hematoma. The risk-score comprises postoperative hematoma volume and density. This tool could ease decision making in follow-up evaluation and indication for recurrence surgery. Yet, further prospective evaluation is required to assess the clinical value of this tool.

journal_name

Clin Neurol Neurosurg

journal_title

Clinical neurology and neurosurgery

authors

Suero Molina E,Borscheid L,Freistühler M,Zawy Alsofy S,Stummer W,Schipmann S

doi

10.1016/j.clineuro.2020.106020

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

106020

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(20)30363-2

journal_volume

195

pub_type

杂志文章

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