Risk Factors for Recurrent Hematoma After Surgery for Acute Traumatic Subdural Hematoma
Heino, Iiro (2019-03-05)
Risk Factors for Recurrent Hematoma After Surgery for Acute Traumatic Subdural Hematoma
(05.03.2019)
Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty.
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe201903118393
https://urn.fi/URN:NBN:fi-fe201903118393
Tiivistelmä
The development of postcraniotomy hematoma (PCH) after surgery for acute traumatic
subdural hematoma (aSDH) has been associated with an increased risk for poor
outcome. The risk factors contributing to PCH remain poorly understood. Our aim was
to study the potential risk factors for PCH in a consecutive series of surgically
evacuated patients with aSDH.
A total of 132 patients with aSDH treated at Turku University Hospital (Turku, Finland)
from 2008 to 2012 were enrolled in the present retrospective cohort study. The
demographic, clinical, laboratory and imaging data were collected from the medical
records. A comprehensive analysis of the data using 6 different univariate methods,
including machine learning and multivariate analyses, was conducted to identify the
factors related to PCH.
The incidence of PCH after primary surgery for traumatic aSDH was 10.6 %. The
patients experiencing PCH were younger (P = 0.04). No difference was found in the use
of anticoagulant or antiplatelet medication for the patients with and without PCH.
Multivariate analyses identified alcohol inebriation at the time of injury (odds ratio
[OR], 12.67; P = 0.041) and hypocapnia (OR, 26.09; P = 0.003) as independent risk
factors for PCH. The patients with PCH had hyponatremia (OR, 0.08; P = 0.018) less
often, and their maximal systolic blood pressure was lower (OR, 0.94; P = 0.009). The
area under the curve for the multivariate model was 0.96 (P = 0.049), with a Youden
index of 0.88.
The results suggest that alcohol inebriation at the time of injury and hypocapnia during
hospitalization are risk factors for the development of PCH.
subdural hematoma (aSDH) has been associated with an increased risk for poor
outcome. The risk factors contributing to PCH remain poorly understood. Our aim was
to study the potential risk factors for PCH in a consecutive series of surgically
evacuated patients with aSDH.
A total of 132 patients with aSDH treated at Turku University Hospital (Turku, Finland)
from 2008 to 2012 were enrolled in the present retrospective cohort study. The
demographic, clinical, laboratory and imaging data were collected from the medical
records. A comprehensive analysis of the data using 6 different univariate methods,
including machine learning and multivariate analyses, was conducted to identify the
factors related to PCH.
The incidence of PCH after primary surgery for traumatic aSDH was 10.6 %. The
patients experiencing PCH were younger (P = 0.04). No difference was found in the use
of anticoagulant or antiplatelet medication for the patients with and without PCH.
Multivariate analyses identified alcohol inebriation at the time of injury (odds ratio
[OR], 12.67; P = 0.041) and hypocapnia (OR, 26.09; P = 0.003) as independent risk
factors for PCH. The patients with PCH had hyponatremia (OR, 0.08; P = 0.018) less
often, and their maximal systolic blood pressure was lower (OR, 0.94; P = 0.009). The
area under the curve for the multivariate model was 0.96 (P = 0.049), with a Youden
index of 0.88.
The results suggest that alcohol inebriation at the time of injury and hypocapnia during
hospitalization are risk factors for the development of PCH.