Analysis of risk factors for postoperative recurrence of chronic subdural hemotoma

Abstract

Objective To explore the risk factors of recurrence of chronic subdural hematoma after drilling and drainage. Methods Clinical data of 142 patients with chronic subdural hematoma admitted to Department of Neurosurgery, Zhongshan Hospital, Xiamen University from January 2013 to December 2016 were collected and retrospectively analyzed. Univariate (chi-square test) and multivariate (logistic regression test) were used to analyze the risk factors for postoperative recurrence of chronic subdural hematoma. Results The postoperative follow-up period of 142 patients was 3 to 24 months. Among them, 21 patients had hematoma after operation and the recurrence rate was 14.8%. Postoperative complications included 4 cases of epilepsy, 2 cases of intracranial infection, 10 cases of subdural effusion, 1 case of intracranial hematoma, and 23 cases of atonic pneumocephalus. Univariate analysis demonstrated that age of onset, anticoagulation, preoperative width of hematoma, preoperative midline shift and postoperative width of subdural space were associated with postoperative recurrence of chronic subdural hematoma (all P<0.05). Multivariate analysis showed that age (OR=20.914, 95%CI: 3.451-126.741), preoperative anticoagulant medication (OR=10.679, 95%CI: 1.873-60.880), preoperative width of hematoma (OR=3.602, 95%CI: 1.029-12.611) and preoperative midline shift (OR=4.613, 95%CI: 1.222-17.418)were significantly associated with postoperative recurrence. Conclusions The postoperative recurrence in patients with chronic subdural hematoma is related to multiple factors. Age ≥70 years, preoperative anticoagulation, preoperative width of hematoma ≥20 mm and preoperative midline shift ≥10 mm were independent risk factors for postoperative recurrence of chronic subdural hemotoma. Key words: Hematoma, subdural, chronic; Recurrence; Risk factor analysis