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Predictors of recurrence and complications after chronic subdural hematoma surgery: a population-based study.

Journal article
Authors J Bartek
K Sjåvik
H Kristiansson
F Ståhl
I Fornebo
P Förander
Asgeir Store Jakola
Published in World neurosurgery
Volume 106
Pages 609-614
ISSN 1878-8769
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 609-614
Language en
Links dx.doi.org/10.1016/j.wneu.2017.07.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Neurosurgery

Abstract

To investigate predictors of recurrence and moderate to severe complications after burr-hole surgery for chronic subdural hematoma (cSDH).A retrospective review was conducted in a Scandinavian single center population-based cohort of 759 adult cSDH patients operated with burr-hole surgery between January 1, 2005 and December 31, 2010. Possible predictors of recurrence and complications, assessed using a standardized reporting system of adverse events, were identified and analyzed in univariable analyses. Variables with a P value < 0.10 were included in a multivariable regression model.Recurrence was observed in 85 patients (11.2%), while moderate to severe complications were observed in 35 (4.6%) patients. Bilateral hematoma (OR 2.05, 95 % CI 1.25-3.35, P<0.01) and largest hematoma diameter in millimeters, (OR 1.05, 95 % CI 1.01-1.09, P<0.01) were independent predictors of recurrence in the multivariable model analysis. Glasgow Coma Score (GCS) of <13 (OR 6.06, 95 % CI 2.72-13.51, P<0.01) and Charlson Comorbidity Index (CCI) >1 (OR 2.28, 95 % CI 1.10-4.75, P=0.03) were independent predictors of moderate to severe complications.Recurrence after cSDH surgery is more often encountered in patients with radiological more extensive disease reflected by bilateral hematoma and large hematoma diameter. In contrary, moderate to severe complications are more often seen in patients in worse clinical condition, reflected by decreased level of consciousness and more comorbidities.

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