当前位置： SCI文献检索 > ACTA NEUROCHIRURGICA期刊下所有文献 > Does time from diagnostic CT until surgical evacuation affect outcome in patients with chronic subdural hematoma?

Does time from diagnostic CT until surgical evacuation affect outcome in patients with chronic subdural hematoma?

Abstract：

BACKGROUND:Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. Patients diagnosed with CSDH's are often planned for subacute surgery. This means that time from diagnostic CT scan until actual surgery might often be prolonged. There are no previous studies that highlight the effect of delayed intervention in this population. METHOD:Patients that underwent surgical evacuation for a CSDH at Skåne University Hospital between 1 January 2015 and 31 December 2016 were included in this retrospective cohort study (n = 179). The primary aim was to determine if time from initial diagnosis by head-CT until surgical evacuation had a significant effect on outcome. The following was assessed by mortality, re-operation, number of days spent in hospital, discharge to home/institution, and functional outcome assessed by GOS. Secondary aims were to evaluate the effect of NOAC, vitamin K antagonists, and antiplatelet drugs on time from CT to surgery and re-operation frequency. RESULTS:Mean time from diagnostic CT scan until surgery was 76 h. No significant relationship was found between time from CT to surgical evacuation and number of days spent in hospital, discharge to own home/institution, 1-year mortality, or outcome assessed by GOS at discharge from hospital. The clear majority (95.5%) of the patients were GCS ≥ 13 pre-operatively. No correlation could be seen between use of NOAC, vitamin K antagonists, or antiplatelet drugs regarding the risk for reoperation within 6 months, and no correlation between the use of these agents and time from CT to surgery. The 30-day mortality was too low to draw any statistically significant conclusions (n = 4). CONCLUSION:In this retrospective cohort study, we could conclude that a delay from initial diagnosis confirming a CSDH to surgical evacuation had no negative effect on outcome when surgery was performed within the time frames and on patients with pre-operatively favorable GCS scores (≥ 13) outlined in our study.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Zolfaghari S,Ståhl N,Nittby Redebrandt H

doi

10.1007/s00701-018-3620-y

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

1703-1709

issue

eissn

0001-6268

issn

0942-0940

pii

10.1007/s00701-018-3620-y

journal_volume

160

pub_type

杂志文章

在线工具

Does time from diagnostic CT until surgical evacuation affect outcome in patients with chronic subdural hematoma?