Lee Seung Woo, Sin Eui Gyu
Department of Neurosurgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Korean J Neurotrauma. 2024 Jun 18;20(2):80-89. doi: 10.13004/kjnt.2024.20.e18. eCollection 2024 Jun.
Chronic subdural hematoma (CSDH) is commonly encountered in neurosurgery, and often occurs in elderly patients following a head injury. Despite favorable postoperative prognosis, recurrence remains common. Herein, we retrospectively analyzed the clinical and radiological data of patients at our institute to identify the risk factors for CSDH recurrence.
We investigated 370 patients who underwent surgery for CSDH at our institute. The following data were analyzed: sex, age, antiplatelet/anticoagulant use, preexisting diseases, radiological parameters, and surgical techniques. A univariate analysis was subsequently performed to examine the association between these variables and CSDH recurrence. Variables with a -value of <0.05 in univariate analysis were further subjected to a multivariate logistic regression model to identify independent risk factors of CSDH.
Of the 370 patients, 345 (93.2%) had no recurrence and 25 (6.8%) had recurrence. Univariate and multivariate analyses revealed that male sex, advanced age, bilateral hematoma, moderate or severe brain atrophy, separation type, gradation type, and burr hole trephination were independent risk factors for CSDH recurrence.
Sex, age, bilateral hematoma, brain atrophy, hematoma density and architecture, and surgical techniques are all associated with CSDH recurrence.
慢性硬膜下血肿（CSDH）在神经外科中较为常见，常发生于头部受伤后的老年患者。尽管术后预后良好，但复发仍很常见。在此，我们回顾性分析了我院患者的临床和影像学数据，以确定CSDH复发的危险因素。
我们调查了我院370例接受CSDH手术的患者。分析了以下数据：性别、年龄、抗血小板/抗凝药物使用情况、既往疾病、影像学参数和手术技术。随后进行单因素分析，以检验这些变量与CSDH复发之间的关联。单因素分析中P值<0.05的变量进一步纳入多因素logistic回归模型，以确定CSDH的独立危险因素。
370例患者中，345例（93.2%）未复发，25例（6.8%）复发。单因素和多因素分析显示，男性、高龄、双侧血肿、中度或重度脑萎缩、分隔型、分层型和钻孔引流是CSDH复发的独立危险因素。
性别、年龄、双侧血肿、脑萎缩、血肿密度和形态以及手术技术均与CSDH复发有关。
