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An association of low high-density lipoprotein levels with recurrence of chronic subdural hematoma

  • Original Article - Brain trauma
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Chronic subdural hematoma (CSDH) is a common illness in neurosurgical practice with a substantial recurrence rate. Previous studies found that serum lipids were associated with the risk of stroke and subarachnoid hemorrhage. In the current study, we aimed to identify the relationship between serum lipids and CSDH recurrence.

Methods

The medical records of 274 consecutive surgical patients with CSDH in our department were reviewed and analyzed. Patients were separated into recurrence and non-recurrence groups. Univariable and multivariable Cox proportional hazards regression analyses were performed to identify serum lipids (triglycerides, total cholesterol, LDL, HDL) and other potential predictors associated with CSDH recurrence, and the performance of predictors was assessed with receiver operating characteristic (ROC) curve.

Results

Of the 274 patients included in the study, 42 (15.3%) experienced at least 1 recurrence of CSDH. Univariate analysis showed that age, hypertension, diabetes mellitus, anticoagulant use, triglycerides, HDL, and midline shift were all significantly associated with CSDH recurrence. Multivariable Cox regression analysis found that only age, diabetes mellitus, midline shift, and HDL level were independent risk factors for CSDH recurrence. A higher HDL level (HR = 0.929, 95% CI 0.905–0.953) was significantly associated with a lower risk of recurrence, and ROC curve analysis revealed that the optimal HDL cut-off value as a predictor was 37.45 mg/dl.

Conclusions

Low level of high-density lipoprotein is significantly associated with recurrence of chronic subdural hematoma.

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Abbreviations

AUC:

Area under the curve

BMI:

Body mass index

CI:

Confidence interval

CSDH:

Chronic subdural hematoma

CT:

Computed tomography

GCS:

Glasgow Coma Scale

HDL:

High-density lipoprotein

HR:

Hazard ratio

LDL:

Low-density lipoprotein

MRI:

Magnetic resonance imaging

ROC:

Receiver operating characteristic

SAH:

Subarachnoid hemorrhage

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Funding

The present study was supported by grants from the Natural Science Foundation of Zhejiang Province, China (LQ20H090008) and Medical Scientific Research Foundation of Zhejiang Province, China (2020RC010). The sponsor had no role in the design or conduct of this research.

Author information

Author notes

  1. Wen-Chao Liu, Qing-Qing Lin and Jing Jin contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Rd., Hangzhou, 310000, Zhejiang, China

    Wen-Chao Liu, Jing Jin, Ming Wang, Wen-Dong You, Jun Gu & Jian-Wei Pan

  2. Department of Gynaecology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, Zhejiang, China

    Qing-Qing Lin

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  1. Wen-Chao Liu
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Correspondence to Jian-Wei Pan.

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Liu, WC., Lin, QQ., Jin, J. et al. An association of low high-density lipoprotein levels with recurrence of chronic subdural hematoma. Acta Neurochir 163, 1061–1068 (2021). https://doi.org/10.1007/s00701-020-04638-6

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  • DOI: https://doi.org/10.1007/s00701-020-04638-6

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