Hirai Satoshi, Yagi Kenji, Hara Keijiro, Kanda Eiichiro, Matsubara Shunji, Uno Masaaki
Departments of1Neurosurgery and.
2Medical Science, Kawasaki Medical School, Kurashiki, Okayama, Japan.
J Neurosurg. 2021 Jan 1;135(4):1203-1207. doi: 10.3171/2020.7.JNS202330. Print 2021 Oct 1.
Because of an aging society, the incidence of chronic subdural hematoma (CSDH) is increasing. This lesion is treated with simple burr hole irrigation, but one of the major issues is that CSDH frequently recurs. ABO blood type may be associated with a bleeding tendency and inflammation. However, its association with the recurrence of CSDH remains unknown. Therefore, the authors of the present study aimed to retrospectively investigate the association between ABO blood type and CSDH recurrence.
The authors retrospectively analyzed symptomatic CSDHs in 425 cerebral hemispheres of 376 patients who had undergone surgical treatment with irrigation of the hematoma via burr holes at their institution from January 2011 to September 2019. Among these were 366 CSDHs in 320 patients whose ABO blood type had been determined and who were included in this study.
In the study, 307 patients with CSDHs in 350 hemispheres were followed up postoperatively until the disappearance of the CDSH or for at least 3 months. Recurrence of CSDH was observed in 37 patients (10.6%) after surgical treatment. Blood type A was found to be significantly associated with CSDH recurrence compared to non-A blood types: 24 of 153 CDSHs (15.7%) versus 13 of 197 CDSHs (6.6%) (p = 0.008). In the multivariable regression analysis, blood type A, in addition to thrombocytopenia, was a significant independent predictor of the recurrence of CSDH.
The study results showed that blood type A is an independent risk factor for the postoperative recurrence of CSDH and that careful follow-up in these patients may be needed.
由于社会老龄化，慢性硬膜下血肿（CSDH）的发病率正在上升。这种病变采用单纯钻孔冲洗治疗，但主要问题之一是CSDH经常复发。ABO血型可能与出血倾向和炎症有关。然而，其与CSDH复发的关联尚不清楚。因此，本研究的作者旨在回顾性研究ABO血型与CSDH复发之间的关联。
作者回顾性分析了2011年1月至2019年9月在其机构接受经钻孔冲洗血肿手术治疗的376例患者的425个脑半球中的症状性CSDH。其中包括320例已确定ABO血型并纳入本研究的患者的366个CSDH。
在该研究中，对350个脑半球中患有CSDH的307例患者进行了术后随访，直至CSDH消失或至少随访3个月。手术治疗后，37例患者（10.6%）出现CSDH复发。与非A型血型相比，发现A型血与CSDH复发显著相关：153个CSDH中有24个（15.7%），而197个CSDH中有13个（6.6%）（p = 0.008）。在多变量回归分析中，除血小板减少外，A型血是CSDH复发的重要独立预测因素。
研究结果表明，A型血是CSDH术后复发的独立危险因素，可能需要对这些患者进行密切随访。
