Cumulative effect of risk factors on recurrence of chronic subdural hematoma after drilling and drainage
10.3760/cma.j.issn.1671-8925.2017.04.017
- VernacularTitle:慢性硬膜下血肿钻孔引流术后复发的危险因素的累积影响
- Author:
Tangming PENG
1
;
Yitian CHEN
;
Liang LIU
;
Ming GUAN
;
Yong JIANG
;
Changren HUANG
;
Ligang CHEN
Author Information
1. 西南医科大学附属医院神经外科
- Keywords:
Chronic subdural hematoma;
Drilling;
Recurrence;
Risk
- From:
Chinese Journal of Neuromedicine
2017;16(4):412-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors of recurrence of chronic subdural hematoma (CSDH) after drilling and drainage,and to explore the cumulative risk of various risk factors in recurrence.Methods A retrospective analysis of 257 patients with CSDH,admitted to and accepted complete drainage in our hospital from January 2010 to December 2015,was performed;234 patients were without recurrence and 23 patients with recurrence.The risk factors of relapse,including age,hypertension,diabetes,hematoma characteristics,preoperative hematoma thickness,preoperative median deviation,hematoma thickness at discharge,midline deviation at discharge and hematoma density,were analyzed.Logistic regression analysis was performed to conform the independent risk factors and cumulative risk of multiple possible risk factors.Results Univariate analysis showed that age,hypertension,diabetes mellitus,preoperative hematoma thickness,preoperative median deviation,hematoma thickness at discharge,midline deviation at discharge and hematoma density were significantly different between the patients without recurrence and patients with recurrence (P＜0.05).Age,diabetes mellitus,preoperative hematoma thickness,and midline shift at discharge were independent risk factors for postoperative drilling recurrence.The cumulative effect of risk factors was that patients with two independent risk factors had a relapse risk of one 4.22-9.50-fold in patients with or without recurrence-independent risk factors,with a risk of recurrence of up to 38.0-fold in patients with three or four independent risk factors.Conclusions The risk factors of recurrence of chronic subdural hematoma after bile duct drainage are age,diabetes mellitus,preoperative hematoma thickness ≥20 mm and midline deviation ≥ 5 mm at discharge.When more independent risk factors are combined,fold increase of cumulative risk of recurrence is noted.
