Prolonged international normalized ratio is independently associated with recurrence of acute subdural hematoma needing reoperation.

Abstract

Acute subdural hematoma (aSDH) removal is one of the most commonly performed procedure in neurosurgery. Complications of those surgeries which require reoperation are associated with higher risk of poor treatment outcome. Therefore we decided to analyse potential factors which might be associated with risk of early reoperation among patients who underwent aSDH surgery. We retrospectively analysed 328 patients treated due to aSDH. From their medical records we obtained detailed medical history. Early reoperation was de ned as reoperation during the same hospital stay. To determine the potential predictors of early reoperation we used univariate and multivariate logistic regression analyses. A total of 20 (6.09%) patients required early reoperation. Those patients had significantly higher International Normalized Ratio (INR) upon admission (1.96 ± 2.55 vs. 1.26 ± 0.50; p <0.01) and significantly higher Prothrombin Time (PT) upon admission (21.84 ± 27.10 vs. 13.40 ± 3.45; p <0.01). In multivariate logistic regression analysis a er adjustment for all possible confounders higher INR (OR: 1.762; 95% CI: 1.017-22.840; p = 0.045) remained independently associated with higher risk of early reoperation among patients with aSDH. Patients with higher INR and PT upon admission are at higher risk of early reoperation. Higher INR is independently associated with higher risk of early reoperation among patients with aSDH.