Clinical Outcomes in Elderly Patients with Chronic Subdural Hematoma: Validation of Irrigation Assignment Based on Hematoma Characteristics
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients and Study Design
2.2. Therapeutic Methods and Surgical Procedures
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Clinical Outcomes
3.3. Predictors of Outcomes in the Elderly Patients
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Aged ≥80 Years | Aged <80 Years | p-Value | |
---|---|---|---|
Number of patients | 96 (44.9) | 118 (55.1) | |
Mean age ± SD (range), years | 86.4 ± 4.8 (80–98) | 70.2 ± 8.7 (31–79) | |
Sex (male) | 62 (64.6) | 86 (72.9) | 0.051 |
Baseline mRS 0–3 | 54 (56.3) | 101 (85.6) | <0.001 |
Patient history | |||
Hypertension | 64 (66.7) | 57 (48.3) | 0.008 |
Diabetes mellitus | 18 (18.8) | 21 (17.8) | 0.139 |
Hyperlipidemia | 12 (12.5) | 13 (11.0) | 0.159 |
Liver disease | 2 (2.1) | 3 (2.6) | 1.000 |
Atrial fibrillation | 12 (12.5) | 4 (3.4) | 0.017 |
Antithrombotic therapy | 32 (33.3) | 23 (19.5) | 0.027 |
GCS upon admission * | |||
3–8 | 2/85 (2.4) | 3/111 (2.7) | 1.000 |
9–12 | 9/85 (10.6) | 3/111 (2.7) | 0.033 |
13–15 | 74/85 (87.0) | 105/111 (94.6) | 0.089 |
Symptom | |||
Headache | 5 (5.2) | 23 (19.5) | 0.002 |
Urinary incontinence | 2 (2.1) | 0 (0) | 0.197 |
Hemiparesis | 61 (63.5) | 74 (62.7) | 0.113 |
Gait disturbance | 30 (31.3) | 31 (26.3) | 0.088 |
Cognitive impairment | 31 (32.3) | 13 (11.0) | <0.001 |
Seizure | 4 (4.2) | 2 (1.7) | 0.187 |
Hematoma | |||
Mean maximum thickness ± SD (range), mm | 24.5 ± 5.7 (7.0–38.0) | 23.3 ± 6.1 (11.3–37.6) | 0.205 |
Mean midline shift ± SD (range), mm | 6.4 ± 4.9 (0–19.3) | 6.6 ± 5.3 (0–19.0) | 0.789 |
Bilateral CSDH | 25 (26.0) | 26 (22.0) | 0.522 |
Therapeutic modality | 0.101 | ||
Simple drainage | 65 (67.7) | 80 (67.8) | |
Drainage with irrigation | 31 (32.3) | 38 (32.2) |
Aged ≥80 Years | Aged <80 Years | p-Value | |
---|---|---|---|
Favorable outcome | 68 (70.8) | 108 (91.5) | <0.001 |
Baseline mRS 0–3 | 53 (98.1) | 97 (96.0) | 0.659 |
Baseline mRS 4–5 | 15 (35.7) | 11 (64.7) | 0.050 |
Mortality | 0 (0) | 0 (0) | - |
Recurrence within 1 year | 10 (10.4) | 3 (2.5) | 0.021 |
Median time to recurrence (IQR), days | 28 (6–140) | 33 (18–44) | 1.000 |
Aged ≥80 Years | Aged <80 Years | |||||
---|---|---|---|---|---|---|
Simple | w/Irrigation | p-Value | Simple | w/Irrigation | p-Value | |
Favorable outcome | 48 (73.8) | 20 (64.5) | 0.350 | 76 (95.0) | 32 (84.2) | 0.074 |
Baseline mRS 0–3 | 37 (97.4) | 16 (100) | 1.000 | 67 (98.5) | 30 (90.9) | 0.101 |
Baseline mRS 4–5 | 11 (40.7) | 4 (26.7) | 0.506 | 9 (75.0) | 2 (40.0) | 0.280 |
Recurrence within 1 year | 5 (7.7) | 5 (16.1) | 0.284 | 3 (3.8) | 0 (0) | 0.550 |
Favorable | Unfavorable | p-Value | |
---|---|---|---|
Number of patients | 68 (70.8) | 28 (29.2) | |
Mean age ± SD (range), years | 85.3 ± 4.6 (80–98) | 87.9 ± 5.2 (80–98) | 0.015 |
Sex (male) | 46 (67.6) | 16 (57.1) | 0.355 |
Baseline mRS 0–3 | 53 (77.9) | 1 (3.6) | <0.001 |
Patient history | |||
Hypertension | 47 (69.1) | 17 (60.7) | 0.479 |
Diabetes mellitus | 14 (20.6) | 4 (14.3) | 0.574 |
Hyperlipidemia | 11 (16.2) | 1 (3.6) | 0.171 |
Liver disease | 1 (3.6) | 1 (1.5) | 0.510 |
Atrial fibrillation | 9 (13.2) | 3 (10.7) | 1.000 |
Antithrombotic therapy | 24 (35.3) | 8 (28.6) | 0.636 |
GCS upon admission * | |||
3–8 | 0/64 (0) | 2/21 (9.5) | 0.063 |
9–12 | 3/64 (4.7) | 6/21 (28.6) | 0.008 |
13–15 | 61/64 (95.3) | 13/21 (61.9) | <0.001 |
Symptom | |||
Headache | 4 (5.9) | 1 (3.6) | 1.000 |
Urinary incontinence | 2 (2.9) | 0 (0) | 1.000 |
Hemiparesis | 39 (57.4) | 22 (78.6) | 0.063 |
Gait disturbance | 27 (39.7) | 3 (10.7) | 0.007 |
Cognitive impairment | 24 (35.3) | 7 (25.0) | 0.472 |
Seizure | 3 (4.4) | 1 (3.6) | 1.000 |
Hematoma | |||
Mean maximum thickness ± SD (range), mm | 24.4 ± 5.7 (11.0–38.0) | 25.3 ± 5.7 (13.0–35.0) | 0.488 |
Mean midline shift ± SD (range), mm | 6.2 ± 5.5 (0–17.6) | 6.9 ± 5.5 (0–19.0) | 0.566 |
Bilateral CSDH | 21 (30.9) | 4 (14.3) | 0.126 |
Therapeutic modality | 0.350 | ||
Simple drainage | 48 (70.6) | 17 (60.7) | |
Drainage with irrigation | 20 (29.4) | 11 (39.3) | |
Recurrence within 1 year | 6 (8.8) | 4 (14.3) | 0.471 |
OR (95% CI) | p-Value | |
---|---|---|
Age, years | 1.07 (0.95–1.20) | 0.255 |
Baseline mRS | 18.10 (4.26–76.90) | <0.001 |
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Maeda, T.; Kikkawa, Y.; Ehara, T.; Tsuchiya, R.; Tabata, S.; Onodera, K.; Kimura, T.; Take, Y.; Suzuki, K.; Kurita, H. Clinical Outcomes in Elderly Patients with Chronic Subdural Hematoma: Validation of Irrigation Assignment Based on Hematoma Characteristics. Life 2024, 14, 518. https://doi.org/10.3390/life14040518
Maeda T, Kikkawa Y, Ehara T, Tsuchiya R, Tabata S, Onodera K, Kimura T, Take Y, Suzuki K, Kurita H. Clinical Outcomes in Elderly Patients with Chronic Subdural Hematoma: Validation of Irrigation Assignment Based on Hematoma Characteristics. Life. 2024; 14(4):518. https://doi.org/10.3390/life14040518
Chicago/Turabian StyleMaeda, Takuma, Yuichiro Kikkawa, Takuro Ehara, Ryosuke Tsuchiya, Shinya Tabata, Koki Onodera, Tatsuki Kimura, Yushiro Take, Kaima Suzuki, and Hiroki Kurita. 2024. "Clinical Outcomes in Elderly Patients with Chronic Subdural Hematoma: Validation of Irrigation Assignment Based on Hematoma Characteristics" Life 14, no. 4: 518. https://doi.org/10.3390/life14040518
APA StyleMaeda, T., Kikkawa, Y., Ehara, T., Tsuchiya, R., Tabata, S., Onodera, K., Kimura, T., Take, Y., Suzuki, K., & Kurita, H. (2024). Clinical Outcomes in Elderly Patients with Chronic Subdural Hematoma: Validation of Irrigation Assignment Based on Hematoma Characteristics. Life, 14(4), 518. https://doi.org/10.3390/life14040518