Analysis of Prognostic Factors for Chronic Subdural Hematoma

Abstract

Objective: Chronic subdural hematoma (CSDH) is a relatively common disease with a simple treatment strategy. However, the prognosis for CSDH patient is not always easily determined. The aim of this study was to investigate the prognostic factors for patients with CSDH. Methods: Forty-six patients who were treated with burrhole trephination surgery for CSDH were retrospectively analyzed. The possible prognostic factors were age, sex, the size of the hematoma, pre-operative midline shifting, density and the location of the hematoma, pre-operative Glasgow Coma Scale (GCS), medical histories, postoperative brain expansion, and post-operative pneumocephalus. Post-operative clinical outcomes were evaluated by modified Rankin Scale (good outcome: mRS 0-1, poor outcome: mRS 2-5). Results: Among 46 patients, 33 patients (72%) were in the good outcome group while 13 (28%) patients demonstrated a poor outcome. Among variable factors, being older than 65 years, a poor pre-operative GCS (6-12) and a history of diabetes were significantly related to a poor clinical outcome statistically. As a result of logistic regression analysis for these factors, being older than 65 years and a pre-operative GCS under 12 were revealed as independent prognostic factors for CSDH. Conclusion: Being older than 65 years and a pre-operative GCS under 12 were independent, significant prognostic factors for CSDH. The presence of diabetes was also statistically related with a poor prognosis without a high-risk value. These results could be helpful to predict the prognosis for CSDH after burrhole trephination. (J Kor Neurotraumatol Soc 2008;4:14-18)