Predictive Factors for Chronic Subdural Hematoma Recurrence

Abstract

Background: Recurrence of chronic subdural hematoma is a major impact on the clinical course during management. Literatures define several factors during their study. Aim of Study: We aimed to investigate the predictive factors that may be responsible for CSDH recurrence in patients who underwent surgical evacuation at our center. Patients and Methods: This was a retrospective analysis of medical records for patients who underwent surgical evac-uation of CSDH at Kasr Al-Ainy University Hospital from July 2018 to August 2020. The diagnosis of CSDH was established by Computed Tomography (CT). The ethical approval was gained prior to data retrieval. The main inclusion criteria is the presence of CSDH on CT scan with neurological sequelae. It has been found that 54 medical records. Eleven cases were excluded from the study sample due to missing data. Finally, 43 patients' file were reviewed for analysis. Routine imaging of post-operative evacuation is achieved in the 1st day, 1st and 3rd months. Results: The mean and standard deviation of age was 64.71±12.65 years, age range 45-88 years. The male patients constituted 76.7% the interval between head trauma (found in 39.5%) and surgery was up to 60 days. Multivariate analysis identified mixed density as the sole predictive value for recurrence (OR=16.8, 95% CI=13.4-20.2, p-value=0.021). Conclusion: Recurrence of an evacuated chronic subdural hematoma is not uncommon phenomena. Presence of acute blood on top of chronic fluid (mixed density) is regarded as a risk factor for recurrence in the first month post-operatively.