Prevalence of and risk factors for recurrence of chronic subdural hematoma
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Chronic subdural hematoma (CSDH) is a common disease in neurosurgical practice with substantial recurrence rate. We aimed to estimate recurrence rate of CSDH and to identify risk factors for CSDH recurrence.
We retrospectively studied consecutive cases with CSDH and performed surgical therapy in our hospital. Univariate and multivariate logistic regression analyses were performed to identify factors associated with recurrence of CSDH.
A total of 226 patients with CSDH were included; 34 patients recurred after surgery with a recurrence rate of 15.0%. Univariate analysis showed that the recurrence group had more patients with homogenous hyper-dense hematoma (20.6 vs 6.3%, p = 0.035) and shorter duration of subdural drainage post-surgery (1.2 ± 1.4 vs 1.5 ± 0.9, p = 0.022) than the non-recurrence group. Logistic regression analysis revealed that duration of subdural drainage (OR = 0.66, p = 0.05) and hyper-dense of hematoma (OR = 4.94, p = 0.012) were independent predictors for CSDH recurrence.
Homogenous hyper-dense of hematoma and duration of subdural drainage post-surgery were independent predictors for CSDH recurrence; longer duration of postoperative subdural drainage was associated with lower risk of recurrence.
KeywordsChronic subdural hematoma Recurrence Prevalence Risk factors Hematoma density
The authors sincerely thank all the doctors in the neurosurgery department of the First Affiliated Hospital of Zhejiang University College of Medicine for their help in conducting this research.
Compliance with ethical standards
The study was approved by the ethics committee of the First Affiliated Hospital, College of Medicine, Zhejiang University, and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was obtained from all individual participants included in the study.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Almenawer SA, Farrokhyar F, Hong C, Alhazzani W, Manoranjan B, Yarascavitch B, Arjmand P, Baronia B, Reddy K, Murty N, Singh S (2014) Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients. Ann Surg 259:449–457. https://doi.org/10.1097/SLA.0000000000000255 CrossRefPubMedGoogle Scholar
- 7.Kiymaz N, Yilmaz N, Mumcu C (2007) Controversies in chronic subdural hematoma: continuous drainage versus one-time drainage. Medical Sci Monitor: Int Medical J experimental Clinical Res 13:Cr240–Cr243Google Scholar
- 17.Santarius T, Kirkpatrick PJ, Ganesan D, Chia HL, Jalloh I, Smielewski P, Richards HK, Marcus H, Parker RA, Price SJ, Kirollos RW, Pickard JD, Hutchinson PJ (2009) Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet (London, England) 374:1067–1073CrossRefGoogle Scholar
- 19.Stanisic M, Hald J, Rasmussen IA, Pripp AH, Ivanovic J, Kolstad F, Sundseth J, Zuchner M, Lindegaard KF (2013) Volume and densities of chronic subdural haematoma obtained from CT imaging as predictors of postoperative recurrence: a prospective study of 107 operated patients. Acta Neurochir 155:323–333. https://doi.org/10.1007/s00701-012-1565-0 CrossRefPubMedGoogle Scholar
- 21.Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S (2008) Independent predictors for recurrence of chronic subdural hematoma: a review of 343 consecutive surgical cases. Neurosurgery 63:1125–1129. https://doi.org/10.1227/01.NEU.0000335782.60059.17 CrossRefPubMedGoogle Scholar
- 22.Tsutsumi K, Maeda K, Iijima A, Usui M, Okada Y, Kirino T (1997) The relationship of preoperative magnetic resonance imaging findings and closed system drainage in the recurrence of chronic subdural hematoma. J Neurosurg 87:870–875. https://doi.org/10.3171/jns.1997.87.6.0870 CrossRefPubMedGoogle Scholar