Analysis on imaging related factors of recurrence of chronic subdural hematoma

doi:10.3877/cma.j.issn.2095-9141.2019.06.006

Abstract

Abstract:

Objective

To evaluate and predict the related factors of chronic subdural hematoma (CSDH) recurrence by imaging examination.

Methods

Clinical data of 113 patients who underwent surgical treatment of CSDH in neurosurgery at the Second Hospital Affiliated to Nantong University from January 2014 to December 2018 were collected. All patients underwent external drainage surgery. The follow-up time was more than 3 months. The clinical data of patients with relapse and non-recurrence were compared. Multivariate logistic regression was used to analyze the risk factors of recurrence in CSDH patients.

Results

Of the 113 patients, 10 had recurrence and 103 had no recurrence, and the recurrence rate was 8.8%. There were no significant differences in gender, age, preoperative hematoma thickness and midline deviation between the relapsed group and the non-recurrent group (P>0.05). The hematoma type and hematoma side of the relapsed group and the non-recurrent group were compared. The differences were statistically significant (P<0.05). Statistically significant variables in the univariate analysis were included in the logistic regression analysis. The results showed that preoperative stratification and bilateral hematoma were independent risk factors for CSDH recurrence.

Conclusion

The risk factors for the recurrence of CSDH are the types of hematoma separation and stratification and bilateral hematoma before imaging.

Key words: Chronic subdural hematoma, Recurrence, Radiological factors

Yi Zhang, Hongyan Yan, Qiang Peng, Yong Dai, Lei Wang. Analysis on imaging related factors of recurrence of chronic subdural hematoma[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(06): 345-348.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2019.06.006

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2019/V05/I06/345

Figures/Tables 2

References 18

[1]	白金鑫，王跃彬，陈宁，等.慢性硬膜下血肿的治疗研究进展[J].临床医药实践, 2018, 27(3): 210-213.
[2]	胡杨杨，戴易.慢性硬膜下血肿治疗新策略[J].沈阳医学院学报, 2018, 20(2): 174-177.
[3]	Lee JM, Park JC, Kim JH. Retrospective analysis of risk factors for recurrent chronic subdural hematoma[J]. Nerve, 2016, 2(2): 54-58.
[4]	Jeong SI, Kim SO, Won YS, et al. Clinical analysis of risk factors for recurrence in patients with chronic subdural hematoma undergoing burr hole trephination[J]. Korean J Neurotrauma, 2014, 10(1): 15-21.
[5]	文传志.慢性硬膜下血肿术后复发因素分析[J].中国社区医师, 2019, 35(1): 73-74.
[6]	胡杨杨，狄广福，徐宗华，等.慢性硬膜下血肿术后复发危险因素分析及防治策略[J].皖南医学院学报, 2018, 37(2): 170-172.
[7]	Delgado Almandoz JE, Yoo AJ, Stone MJ, et al. The spot sign score in primary intracerebral hemorrhage identifies patients at highest risk of in-hospital mortality and poor outcome among survivors[J]. Stroke, 2010, 41(1): 54-60.
[8]	Li Q, Liu QJ, Yang WS, et al. Island sign: an imaging predictor for early hematoma expansion and poor outcome in patients with intracerebral hemorrhage[J]. Stroke, 2017, 48(11): 3019-3025.
[9]	Kuwabara M, Sadatomo T, Yuki K, et al. The effect of irrigation solutions on recurrence of chronic subdural hematoma: a consecutive cohort study of 234 patients[J]. Neurol Med Chir (Tokyo), 2017, 57(5): 210-216.
[10]	Kim J, Moon J, Kim T, et al. Risk factor analysis for the recurrence of chronic subdural hematoma: a review of 368 consecutive surgical cases[J]. Korean J Neurotrauma, 2015, 11(2): 63-69.
[11]	Hammer A, Tregubow A, Kerry G, et al. Predictors for recurrence of chronic subdural hematoma[J]. Turk Neurosurg, 2016, 27(5): 756-762.
[12]	Yan C, Yang MF, Huang YW. A reliable nomogram model to predict the recurrence of chronic subdural hematoma after burr hole surgery[J]. World Neurosurg, 2018, 118: e356-e366.
[13]	Yamamoto H, Hirashima Y, Hamada H, et al. Independent predictors of recurrence of chronic subdural hematoma: results of multivariate analysis performed using a logistic regression model[J]. J Neurosurg, 2003, 98(6): 1217-1221.
[14]	Lee JM, Park JC, Kim JH. Retrospective analysis of risk factors for recurrent chronic subdural hematoma[J]. Nerve, 2016, 2(2): 54-58.
[15]	Jung YG, Jung NY, Kim E. Independent predictors for recurrence of chronic subdural hematoma[J]. J Korean Neurosurg Soc, 2015, 57(4): 266-270.
[16]	Hammer A, Tregubow A, Kerry G, et al. Predictors for recurrence of chronic subdural hematoma[J]. Turk Neurosurg, 2017, 27(5): 756-762.
[17]	Tokmak M, Iplikcioglu AC, Bek S, et al. The role of exudation in chronic subdural hematomas[J]. J Neurosurg, 2007, 107(2): 290-295.
[18]	Song DH, Kim YS, Chun HJ, et al. The predicting factors for recurrence of chronic subdural hematoma treated with burr hole and drainage[J]. Korean J Neurotrauma, 2014, 10(2): 41-48.

因素		复发组(n=10)	非复发组(n=103)	t/χ²值	P值
性别		?	?	0.002	0.965
?	男	8(80%)	83(81%)	?	?
?	女	2(20%)	20(19%)	?	?
年龄		61.9±7.6	64.7±20.7	-0.084	0.935
血肿的术前厚度(mm)		?	?	0.896	0.344
?	<20	2(20%)	42(41%)	?	?
?	≥20	8(80%)	61(59%)	?	?
血肿类型		?	?	21.820	<0.001
?	高密度	1(10%)	11(11%)	?	?
?	等密度	0(0%)	15(15%)	?	?
?	低密度	1(10%)	41(40%)	?	?
?	混合密度	2(20%)	27(26%)	?	?
?	分隔分层	6(60%)	9(9%)	?	?
中线偏移(mm)		?	?	0.456	0.500
?	<10	0(0%)	13(13%)	?	?
?	≥10	10(100%)	90(87%)	?	?
血肿侧别		?	?	3.920	0.048
?	单侧	6(60%)	91(88%)	?	?
?	双侧	4(40%)	12(12%)	?	?

因素		复发组(n=10)	非复发组(n=103)	t/χ²值	P值
性别		?	?	0.002	0.965
?	男	8(80%)	83(81%)	?	?
?	女	2(20%)	20(19%)	?	?
年龄		61.9±7.6	64.7±20.7	-0.084	0.935
血肿的术前厚度(mm)		?	?	0.896	0.344
?	<20	2(20%)	42(41%)	?	?
?	≥20	8(80%)	61(59%)	?	?
血肿类型		?	?	21.820	<0.001
?	高密度	1(10%)	11(11%)	?	?
?	等密度	0(0%)	15(15%)	?	?
?	低密度	1(10%)	41(40%)	?	?
?	混合密度	2(20%)	27(26%)	?	?
?	分隔分层	6(60%)	9(9%)	?	?
中线偏移(mm)		?	?	0.456	0.500
?	<10	0(0%)	13(13%)	?	?
?	≥10	10(100%)	90(87%)	?	?
血肿侧别		?	?	3.920	0.048
?	单侧	6(60%)	91(88%)	?	?
?	双侧	4(40%)	12(12%)	?	?

因素		偏回归系数	标准误	Wald值	OR值	95%CI	P值
血肿类型		?	?	?	?	?	?
?	非分隔	?	?	?	1(Ref)	?	?
?	分隔	3.705	1.406	2.636	40.658	-7.155~-0.990	0.008
血肿侧别		?	?	?	?	?	?
?	单侧	?	?	?	1(Ref)	?	?
?	双侧	3.964	1.475	2.687	52.646	1.133~7.795	0.007

因素		偏回归系数	标准误	Wald值	OR值	95%CI	P值
血肿类型		?	?	?	?	?	?
?	非分隔	?	?	?	1(Ref)	?	?
?	分隔	3.705	1.406	2.636	40.658	-7.155~-0.990	0.008
血肿侧别		?	?	?	?	?	?
?	单侧	?	?	?	1(Ref)	?	?
?	双侧	3.964	1.475	2.687	52.646	1.133~7.795	0.007

Please choose a citation manager

Content to export