医学
慢性硬膜下血肿
血肿
硬膜下血肿
队列
外科
队列研究
急性硬膜下血肿
内科学
作者
John J.Y. Zhang,Shilin Wang,Aaron Song Chuan Foo,Ming Yang,Boon Leong Quah,Ira Siyang Sun,Zhi Xu Ng,Kejia Teo,Boon Chuan Pang,Eugene Weiren Yang,Sein Lwin,Ning Chou,Shiong Wen Low,Tseng Tsai Yeo,Thomas Santarius,Vincent Diong Weng Nga
标识
DOI:10.1016/j.wneu.2019.07.168
摘要
Although the use of a postoperative drain after burr-hole evacuation of chronic subdural hematoma (CSDH) is known to improve surgical outcomes, the superiority of subdural over subperiosteal drains has not been firmly established. Evidence comparing these 2 drain types is largely restricted to single-center series with limited numbers. Using a multicenter cohort study, we aimed to show noninferiority of subperiosteal drains vis-à-vis subdural drains after burr-hole evacuation of CSDH.We performed a retrospective analysis of all consecutive patients with CSDH aged 21 years and older who had undergone burr-hole craniostomy across 3 tertiary hospitals from 2010 to 2017. Primary outcome measures included CSDH recurrence and modified Rankin Scale (mRS) score at 6 months. Outcomes of patients in the subdural and subperiosteal drain groups were analyzed and confounders were adjusted for using multivariate logistic regression.Of the 570 cases analyzed, 329 (57.7%) received a subdural drain and 241 (42.3%) received a subperiosteal drain. There was no significant difference between the 2 drain groups in CSDH recurrence (13.1% in the subdural group vs. 11.2% in the subperiosteal group; P = 0.502) or 6-month mRS score (27.2% with mRS 4-6 in the subdural group vs. 20.4% in the subperiosteal group; P = 0.188). Independent predictors of CSDH recurrence identified on multivariate analysis included premorbid mRS score 0-3 (P = 0.021), separated CSDH type on preoperative computed tomography scan (P = 0.002), and postoperative pneumocephalus of ≥15 mm (P = 0.005).Outcomes of subdural and subperiosteal drains after burr-hole craniostomy for CSDH are largely equivalent based on our findings.
科研通智能强力驱动
Strongly Powered by AbleSci AI