Vaibhav Kumar, Sahu Anurag, Prasad Ravi Shankar, Deb Debabrata, Kumar Devendra, Karimi Abjad
Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Asian J Neurosurg. 2024 Aug 21;19(4):707-714. doi: 10.1055/s-0044-1789247. eCollection 2024 Dec.
Chronic subdural hematoma (CSDH) is a common neurological problem with significant recurrence after surgery. Risk considerations can vary, ranging from patient-related factors to those related to the surgical procedure. This study explores the association between preoperative eosinophil count and systemic immune inflammation (SII) with CSDH recurrence. We conducted a prospective analysis of 105 patients with equal numbers of CSDHs who underwent surgery for CSDH between January 2023 and January 2024. The preoperative eosinophil counts, along with other differential leukocyte counts, were measured. The SII index was calculated using the standard formula (SII = neutrophil count × platelet count/lymphocyte count). Multivariate and univariate regression analyses were performed to assess the association between risk factors and CSDH recurrence. The preoperative eosinophil count showed a significant correlation with recurrence ( < 0.001). The SII index was significantly higher in patients with recurrent CSDH ( = 0.003). Neutrophils were found to be significantly associated with CSDH recurrence ( = 0.038). Age ( < 0.001) and SII ( = 0.005) were found to be independent predictors of CSDH recurrence, whereas hematoma volume ( < 0.001) and the antiplatelet regimen were a significant predictor of CSDH recurrence ( = 0.047). Variables like male gender, diabetes mellitus, anticoagulants, and hematoma volume were associated with eosinophil-rich or eosinophil-poor status. Preoperative eosinophil count, neutrophils, and the SII index may serve as potential predictors of CSDH recurrence. Further studies with larger sample sizes are needed to validate these findings.
慢性硬膜下血肿（CSDH）是一种常见的神经学问题，术后复发率较高。风险考量因素多种多样，从患者相关因素到手术操作相关因素不等。本研究探讨术前嗜酸性粒细胞计数和全身免疫炎症（SII）与CSDH复发之间的关联。
我们对2023年1月至2024年1月期间接受CSDH手术的105例CSDH患者进行了前瞻性分析，这些患者数量相等。测量了术前嗜酸性粒细胞计数以及其他白细胞分类计数。使用标准公式计算SII指数（SII = 中性粒细胞计数×血小板计数/淋巴细胞计数）。进行多变量和单变量回归分析以评估风险因素与CSDH复发之间的关联。
术前嗜酸性粒细胞计数与复发显著相关（P < 0.001）。复发性CSDH患者的SII指数显著更高（P = 0.003）。发现中性粒细胞与CSDH复发显著相关（P = 0.038）。年龄（P < 0.001）和SII（P = 0.005）被发现是CSDH复发的独立预测因素，而血肿体积（P < 0.001）和抗血小板治疗方案是CSDH复发的显著预测因素（P = 0.047）。男性性别、糖尿病、抗凝剂和血肿体积等变量与富含嗜酸性粒细胞或嗜酸性粒细胞缺乏状态相关。
术前嗜酸性粒细胞计数、中性粒细胞和SII指数可能作为CSDH复发的潜在预测指标。需要更大样本量的进一步研究来验证这些发现。
