Introduction: The purpose of this study is to investigate 30-day outcomes of subdural hematoma evacuation in patients with end-stage renal disease (ESRD) requiring hemodialysis.
Methods: The American College of Surgeons National Surgical Quality Improvement Program database (2012 – 2014) was queried. We included adult patients who underwent subdural hematoma evacuation, and compared 30-day outcomes (including readmissions, reoperations, morbidity, and mortality) between patients with dialysis requirement and no dialysis requirement (controls).
Results: A total of 1,047 cases were identified, with 43 patients in the ESRD group (4.1%). The 30-day readmission rate was 4.7% and 7.5% for patients with ESRD and controls (p=0.488); the 30-day reoperation rate was 7.0% and 9.7% for cases and controls (p=0.558); the 30-day morbidity rate was 46.5% for patients with ESRD and 24.7% for controls (p=0.001); and the 30-day mortality rate was 44.2% vs. 14.0% for patients with and without ESRD, respectively (p<0.001). On multiple logistic regression analysis, ESRD was an independent predictor of 30-day mortality (OR 3.54; 95% CI, 1.83 – 6.83; p<0.001), but not for 30-day complications (OR 1.68; 95% CI, 0.87 – 3.23; p=0.118).
Conclusions: The findings of the present study suggest that for patients with ESRD who develop subdural hematomas requiring evacuation, the 30-day mortality rate is 3.5 times higher when compared to patients without ESRD.
Patient Care: 1. Provide surgeons with data regarding 30-day outcomes (including morbidity and mortality) for patients with end-stage renal disease requiring subdural hematoma evacuation
Learning Objectives: 1. Understand 30-day outcomes after subdural hematoma evacuation in patients with end-stage renal disease