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KMID : 1143720080040010014
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Korean Journal of Neurotrauma
2008 Volume.4 No. 1 p.14 ~ p.18
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Analysis of Prognostic Factors for Chronic Subdural Hematoma
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Kim Young-Il
Min Byung-Kook
Hwang Sung-Nam
Nam Taek-Kyun
Lee Jung-Hoon
Park Seung-Won
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Abstract
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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.
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KEYWORD
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Chronic Subdural Hematoma, Burrhole trephination, Prognostic factor
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