J Korean Neurotraumatol Soc.  2008 Jun;4(1):14-18. 10.13004/jknts.2008.4.1.14.

Analysis of Prognostic Factors for Chronic Subdural Hematoma

• Kim YI
• Lee JH
• Park SW
• Nam TK
• Min BK
• Hwang SN

• KMID: 1814437
• DOI: http://doi.org/10.13004/jknts.2008.4.1.14

Abstract

OBJECTIVE
Chronic subdural hematoma (CSDH) is a relatively common disease with a simple treatment strategy. However, the prognosis for CSDH patient is not always easily determined. The aim of this study was to investigate the prognostic factors for patients with CSDH.
METHODS
Forty-six patients who were treated with burrhole trephination surgery for CSDH were retrospectively analyzed. The possible prognostic factors were age, sex, the size of the hematoma, pre-operative midline shifting, density and the location of the hematoma, pre-operative Glasgow Coma Scale (GCS), medical histories, post-operative brain expansion, and post-operative pneumocephalus. Post-operative clinical outcomes were evaluated by modified Rankin Scale (good outcome: mRS 0-1, poor outcome: mRS 2-5).
RESULTS
Among 46 patients, 33 patients (72%) were in the good outcome group while 13 (28%) patients demonstrated a poor outcome. Among variable factors, being older than 65 years, a poor pre-operative GCS (6-12) and a history of diabetes were significantly related to a poor clinical outcome statistically. As a result of logistic regression analysis for these factors, being older than 65 years and a pre-operative GCS under 12 were revealed as independent prognostic factors for CSDH.
CONCLUSION
Being older than 65 years and a pre-operative GCS under 12 were independent, significant prognostic factors for CSDH. The presence of diabetes was also statistically related with a poor prognosis without a high-risk value. These results could be helpful to predict the prognosis for CSDH after burrhole trephination.

Keyword

Chronic subdural hematoma; Burrhole trephination; Prognostic factor

MeSH Terms

Brain
Glasgow Coma Scale
Hematoma
Hematoma, Subdural, Chronic
Humans
Logistic Models
Pneumocephalus
Prognosis
Retrospective Studies

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