• World Neurosurg · Dec 2020

    Review

    Outcomes of Surgical Evacuation of Chronic Subdural Hematoma in the Aged: Institutional Experience and Systematic Review.

    • Ehsan Dowlati, Kwadwo Sarpong, Matthew Triano, Stanley Kamande, Jordan Black, Jeffrey C Mai, Amjad N Anaizi, and Daniel R Felbaum.
    • Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA. Electronic address: edowlati@gmail.com.
    • World Neurosurg. 2020 Dec 1; 144: 270-282.e1.

    BackgroundSurgical intervention for chronic subdural hematoma (cSDH) in the elderly population remains a clinical challenge given that associated morbidity and outcomes do not always equate radiographic success with clinical success. Our objective was to compare outcome measures of 2 age groups of patients undergoing surgical intervention for cSDH evacuation and to perform a systematic review of the literature related to this topic.MethodsA retrospective analysis of adult patients undergoing surgical evacuation of cSDH at our institution was performed. Primary outcome measures of modified Rankin Scale (mRS) score at discharge and 3 months were assessed. In addition, a systematic search was performed to collect all relevant studies addressing outcomes after surgical intervention in aged patients with cSDH.ResultsThere were 72 patients in the younger cohort (<70 years) and 113 patients in the aged cohort (≥70 years). Multivariate analysis showed significant association between age and higher mRS score at discharge and 3 months follow-up. There were also significant differences in length of stay and disposition between the 2 groups. Twenty-one studies were reviewed, and 11 studies were included in a meta-analysis of recurrence rates between studied age groups.ConclusionsThe aged cohort had worse outcomes than the younger cohort as determined by mRS score at discharge and 3 months. A systematic review of outcomes is provided with limited meta-analysis because of the heterogenous nature of outcome reporting and the observational design of previous studies. Further studies with standardized reporting and long-term follow-up are warranted to further study outcomes in this increasing population.Copyright © 2020 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…