|Paper title||Predictors of outcome, complications, and recurrence after chronic subdural hematoma surgery|
|Form of presentation||Poster|
Chronic subdural hematoma (cSDH) is a frequent indication for neurosurgery in elderly patients. We were interested in predictors of outcome and complications of surgery (burr-hole or craniotomy) for cSDH.
For all patients undergoing surgery for cSDH from 2013-2017, we analyzed several clinical and radiological variables taken from our prospective patient registry. Outcome was measured with the Karnofsky Performance Scale (KPS). Complications were assessed according to the Clavien-Dindo grade (CDG).
From a total of 435 cases, 166 (38.3%) presented a complication during the first 3 postoperative months. The CDG was grade 1 in 23 cases (5.3%), grade 2 in 62 (14.3%), 3a in 7 (1.6%), 3b in 64 (14.7%), 4a in 2 (0.5%), and 5 in 8 (1.8%). A change in KPS correlated with CDG (Spearman’s rho = -0.27, p < 0.001). A lack of improvement in KPS was predicted by the Charlson-Comorbidity-Index (CCI) > 1 (OR 2.11, 95% CI 1.30 – 3.43, p = 0.003).
Our data indicate that surgery for cSDH is a safe procedure despite the high average age of this patient population. Patient related comorbidities, as reflected by the CCI, seem to be the most relevant for patient outcome.