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  • Independent predictors for recurrence of chronic subdural hematoma

    Final Number:
    1379

    Authors:
    Jong-Myong Lee MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: Chronic subdural hematoma is characterized by blood in the subdural space evokes an inflammatory reaction. Numerous factors potentially associated with recurrence of chronic subdural hematoma have been reported, but the factors influencing their recurrence have not been sufficiently investigated yet. We evaluated the risk factors of recurrence.

    Methods: We analyzed the data of 420 patients with chronic subdural hematoma treated by a standard surgical procedure for hematoma evacuation in our institution.

    Results: Ninety-two (21.9%) experienced at least 1 recurrence of chronic subdural hematoma during the study period. The recurrence rate in the homogeneous type was 7%, 21% in the laminar type, 38% in the separated type, and 0% in the trabecular type. The rate of recurrence was significantly lower in the homogeneous and the trabecular type than the laminar and separated type. We performed a multivariate logistic regression analysis and found that postoperative midline shifting (odds ratio, 3.572; 95% confidence interval, 1.618~7.885; P= 0.001), diabetes mellitus (odds ratio, 2.148; 95% confidence interval, 1.196~3.856; P= 0.010), history of seizure (odds ratio, 2.564; 95% confidence interval, 1.210~5.430; P= 0.014), width of hematoma (odds ratio, 2.134; 95% confidence interval, 1.287~3.538; P= 0.003), and anticoagulant therapy (odds ratio, 2.738; 95% confidence interval, 1.424~6.960; P= 0.005, are an independent risk factor for the recurrence of chronic subdural hematoma. We could not find any significant difference between chronic subdural hematoma recurrence and current antiplatelet.

    Conclusions: We have shown that patients with postoperative midline shifting (> 5mm), diabetes mellitus, preoperative seizure, preoperative width of hematoma (> 20mm), and anticoagulant therapy were an independent predictor for the recurrence of chronic subdural hematoma. According to internal architecture of hematoma, the rate of recurrence was significantly lower in the homogeneous and the trabecular type than the laminar and separated type.

    Patient Care: Our result is independent predictor of recurrence.

    Learning Objectives: We have shown that patients with postoperative midline shifting (? 5mm), diabetes mellitus, preoperative seizure, preoperative width of hematoma (? 20mm), and anticoagulant therapy were an independent predictor for the recurrence of chronic subdural hematoma.

    References:

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