| Chronic Subdural Hematoma in Elderly Patients: Consideration of Preoperative Risk Factors for Recurrence |
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Woong Bae Park , Young Il Kim , Chul Bum Cho , Seung Ho Yang , IL Sup Kim , Jae Taek Hong , Jae Hoon Sung , Sang Won Lee |
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Department of Neurosurgery, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea |
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| Abstract |
Objective
Chronic subdural hematoma (CSDH), one of the most frequently treated disease in neurosurgical department, is especially troublesome in elderly patients. In this study, we investigated the preoperative prognostic factors for recurrence in elderly patients.
Methods
We reviewed 254 patients with CSDH treated by surgery between 2010 and 2015, retrospectively. Among them, total 174 patients aged over 65 years old were enrolled in this study. In preoperative computerized tomography (CT) scan, hematoma density was classified into four groups.
Results
The overall (all age) recurrence rate was 13.4% (34/254). A recurrence rate in old age (≥65 years old) and young age (<65 years old) were 10.9%(19/174) and 18.8%(15/80), respectively. Among total 174 patients, no recurrence group was 155 (89.1%) and recurrence group was 19 (10.9%) In presenting symptoms, headache was most common in both group and statistically significant between two groups (52.9% vs. 78.9%, p=0.031).Also, in recurrence group, anticoagulant administration rate is higher than no recurrence group (1.9% vs. 15.8%, p=0.018). It is observed that high recurrence tendency in high (OR: 7.091, 95% CI: 0.663 to 11.139, p-value: 0.105) and mixed (OR: 4.608, 95% CI: 0.578 to 36.756, p-value: 0.149) density, respectively.
Conclusion
In this study, we recognized that headache and administration of anticoagulant were risk factors in our cases. For preoperative radiologic findings, recurrence tends to occur more frequently in case of high or mixed hematoma density. |
| Key Words:
Chronic subdural hematoma, Aged, Recurrence, Risk factor |
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