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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Risk assessment in chronic subdural haematoma evaluated in 148 patients – a simple score for predicting recurrence

Risikobewertung bei chronischen subduralen Hämatomen bei 148 Patienten – ein einfacher Wert für die Vorhersage von Rezidiven

Meeting Abstract

  • presenting/speaker Eric Suero Molina - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Lisa Borscheid - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Moritz Freistühler - Universitätsklinikum Münster, Controlling Department, Münster, Deutschland
  • Walter Stummer - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Stephanie Schipmann-Miletic - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP195

doi: 10.3205/20dgnc480, urn:nbn:de:0183-20dgnc4804

Published: June 26, 2020

© 2020 Suero Molina et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Chronic subdural hematoma (CSDH) is a frequent disease in neurosurgical practice. However, a considerable recurrence rate keeps this condition challenging to treat. We aimed to provide a simple tool for risk assessment in these patients.

Methods: We conducted a retrospective analysis of surgically treated patients with chronic subdural hematomas. In addition to patients’ demographics, radiological assessment included volume, thickness, midline shift and density of hematomas. Statistically significant variables in univariate analysis were further analyzed in a multivariate logistic regression model to create a risk score for recurrence of CSDH.

Results: A total of 148 patients were identified and included for analysis. 50.7% (n=75) were older than 76 years of age. The overall hematoma recurrence rate requiring surgery was 23.6% (n=35). Preoperative hematoma thickness >30mm, as well as preoperative thrombocytopenia, midline shift >6 mm, hematoma volume >80ml and overall hematoma density >45 Hounsfield Units (HU), were significantly more frequent in the recurrence group. Furthermore, after multivariate assessment, preoperative hematoma thickness, thrombocytopenia, postoperative midline shift and hematoma density were independent risk factors and included in the risk assessment tool. Patients were divided into 3 risk groups corresponding to the total scores.

Conclusion: We provide a simple risk-score assessment for predicting recurrence of subdural hematoma. However, since therapy algorithms differ remarkably between neurosurgical services, it remains to be seen if these results are applicable to other institutions. A prospective study that evaluates the reliability and validity of this risk-score in different institutions is therefore needed to assess the clinical value of this tool.