Balser David, Farooq Sameer, Mehmood Talha, Reyes Marleen, Samadani Uzma
New York Harbor Healthcare System, Manhattan Veterans Administration, New York;
Department of Neurosurgery, New York University School of Medicine; and.
J Neurosurg. 2015 Nov;123(5):1209-15. doi: 10.3171/2014.9.JNS141550. Epub 2015 Mar 20.
Chronic subdural hematomas (SDHs) are more common among veterans and elderly persons than among members of the general population; however, precise incidence rates are unknown. The purposes of this study were 1) to determine the current incidence of chronic SDH in a US Veterans Administration (VA) population and 2) to create a mathematical model for determining the current and future incidence of chronic SDH as a function of population age, sex, and comorbidity in the United States VA and civilian populations.
To determine the actual number of veterans who received a radiographic diagnosis and surgical treatment for SDH during 2000-2012, the authors used the VISN03 VA database. On the basis of this result and data from outside the United States, they then created a mathematical model accounting for age, sex, and alcohol consumption to predict the incidence of SDH in the VA and civilian populations during 2012-2040.
Of 875,842 unique (different patient) visits to a VA hospital during the study period, 695 new SDHs were identified on CT images. Of these 695 SDHs, 203 (29%) required surgical drainage. The incidence rate was 79.4 SDHs per 100,000 persons, and the age-standardized rate was 39.1±4.74 SDHs per 100,000 persons. The authors' model predicts that incidence rates of chronic SDH in aging United States VA and civilian populations will reach 121.4 and 17.4 cases per 100,000 persons, respectively, by 2030, at which time, approximately 60,000 cases of chronic SDH will occur each year in the United States.
The incidence of chronic SDH is rising; SDH is projected to become the most common cranial neurosurgical condition among adults by the year 2030.
慢性硬膜下血肿（SDH）在退伍军人和老年人中比在普通人群中更常见；然而，确切的发病率尚不清楚。本研究的目的是：1）确定美国退伍军人事务部（VA）人群中慢性SDH的当前发病率；2）创建一个数学模型，以确定美国VA和民用人口中慢性SDH的当前和未来发病率与人口年龄、性别和合并症的函数关系。
为了确定2000 - 2012年期间接受SDH影像学诊断和手术治疗的退伍军人的实际数量，作者使用了VISN03 VA数据库。基于这一结果和美国以外的数据，他们随后创建了一个考虑年龄、性别和酒精消费的数学模型，以预测2012 - 2040年期间VA和民用人口中SDH的发病率。
在研究期间，875,842次对VA医院的独特（不同患者）就诊中，CT图像上发现了695例新的SDH。在这695例SDH中，203例（29%）需要手术引流。发病率为每10万人中79.4例SDH，年龄标准化发病率为每10万人中39.1±4.74例SDH。作者的模型预测，到2030年，美国老龄化的VA和民用人口中慢性SDH的发病率将分别达到每10万人中121.4例和17.4例，届时美国每年将发生约60,000例慢性SDH。
慢性SDH的发病率正在上升；预计到2030年，SDH将成为成年人中最常见的颅脑神经外科疾病。
