| Influence of Antiplatelet Medication on Recurrence of Chronic Subdural Hemorrhage In Elderly Patients |
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Sei-Youn Yang , Sang-Bok Lee , Kyoung-Suok Cho , Do-Sung Yoo , Tae-Gyu Lee , Pil-Woo Huh |
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Department of Neurosurgery, Uijongbu St. Mary’s Hospital, The Catholic University, School of Medicine, Uijongbu, Korea |
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| Abstract |
Objective
Chronic subdural hemorrhage (CSDH) is one of the most common intracranial hemorrhages in elderly patients. Antiplatelet aggregation agents (APA) are widely used as secondary prevention for vascular disease. The use of APA will continue to increase and this increase is already apparent in elderly patients. The objective of this study was to evaluate the relation between the recurrence of CSDH and preoperative APA medication.
Methods
Ninety nine patients (>65 years old) diagnosed with CSDH were involved in this study. We analyzed the association between the recurrence of CSDH and risk factors including the use of APA, laterality (unilateral or bilateral), width of hemorrhage, the pre/postoperative midline displacement and co-morbidity, focusing on preoperative APA medication.
Results
For the recurrence of CSDH that occurred in 11 patients (11.1%). Among various risk factors, preoperative APA medication (p=0.01) and pre/postoperative midline displacements on CT scan (p=0.00) were associated with the recurrence of CSDH with statistical significance by univariate analysis. Furthermore, multivariate analysis revealed that postoperative APA medication (OR, 4.4; 95% CI, 1.10-17.93; p=0.02) and postoperative midline displacement (OR, 9.6; 95% CI, 2.33-40.0; p=0.00) were independent predictors for CSDH recurrence.
Conclusion
We have shown that preoperative APA medication and postoperative midline shifting of more than 10mm were independent predictors of the recurrence of chronic subdural hematoma. |
| Key Words:
Chronic subdural hematomaㆍAntiplatelet agentㆍRecurrence |
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