Factors that negatively influence the Glasgow Outcome Scale in patients with chronic subdural hematomas. An analytical and retrospective study in a tertiary center
•Chronic subdural hematomas are a frequent pathology, especially in elderly patients.•There is multiple factors that can influence the prognosis of patients.•We analyzed 281 patients and evaluated those that are related to worse GOS. Subdural hematomas are one of the most frequent types of intracran...
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| Published in: | Interdisciplinary neurosurgery : Advanced techniques and case management Vol. 20; p. 100606 |
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01-06-2020
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| Abstract | •Chronic subdural hematomas are a frequent pathology, especially in elderly patients.•There is multiple factors that can influence the prognosis of patients.•We analyzed 281 patients and evaluated those that are related to worse GOS.
Subdural hematomas are one of the most frequent types of intracranial hemorrhage, but there are very few references to explain how different factors can influence the prognosis of these patients. We have tried to establish with statistical significance several elements that influence the Glasgow Outcome Scale at 12 months of follow-up.
We have collected clinical data from January 2008 to January 2018 of all patients admitted to our hospital with a diagnosis of Subdural Hematoma. We classified them in Chronic Subdural Hematoma, Subdural Subacute Chronic Hematoma and Chronic Subdural Hematoma with acute bleeding. From the collected cases, various demographic characteristics, clinical and pharmacological background, radiological, surgical, follow-up and prognostic features were defined, and a statistical analysis was performed to look for significant variables.
A total of 281 patients were analyzed, after performing the statistical analysis (univariate and multivariate analysis) of the multiple variables of the population, statistically significant associations were found in relation to unfavourable GOS at 12 months for the following sections: age, Glasgow Coma Scale on admission, Glasgow Outcome Scale on admission, midline deviation, use of anticoagulant and antiplatelet treatment and intrahematoma septae.
Chronic subdural hematomas, in a high percentage, are subsidiary of surgical treatment. There are several factors that negatively influence the prognosis in patients and that should be considered for both the surgical decision and patient/family agreement and for the medium/long-term follow-up of them. |
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| AbstractList | Background: Subdural hematomas are one of the most frequent types of intracranial hemorrhage, but there are very few references to explain how different factors can influence the prognosis of these patients. We have tried to establish with statistical significance several elements that influence the Glasgow Outcome Scale at 12 months of follow-up. Methods: We have collected clinical data from January 2008 to January 2018 of all patients admitted to our hospital with a diagnosis of Subdural Hematoma. We classified them in Chronic Subdural Hematoma, Subdural Subacute Chronic Hematoma and Chronic Subdural Hematoma with acute bleeding. From the collected cases, various demographic characteristics, clinical and pharmacological background, radiological, surgical, follow-up and prognostic features were defined, and a statistical analysis was performed to look for significant variables. Results: A total of 281 patients were analyzed, after performing the statistical analysis (univariate and multivariate analysis) of the multiple variables of the population, statistically significant associations were found in relation to unfavourable GOS at 12 months for the following sections: age, Glasgow Coma Scale on admission, Glasgow Outcome Scale on admission, midline deviation, use of anticoagulant and antiplatelet treatment and intrahematoma septae. Conclusions: Chronic subdural hematomas, in a high percentage, are subsidiary of surgical treatment. There are several factors that negatively influence the prognosis in patients and that should be considered for both the surgical decision and patient/family agreement and for the medium/long-term follow-up of them. •Chronic subdural hematomas are a frequent pathology, especially in elderly patients.•There is multiple factors that can influence the prognosis of patients.•We analyzed 281 patients and evaluated those that are related to worse GOS. Subdural hematomas are one of the most frequent types of intracranial hemorrhage, but there are very few references to explain how different factors can influence the prognosis of these patients. We have tried to establish with statistical significance several elements that influence the Glasgow Outcome Scale at 12 months of follow-up. We have collected clinical data from January 2008 to January 2018 of all patients admitted to our hospital with a diagnosis of Subdural Hematoma. We classified them in Chronic Subdural Hematoma, Subdural Subacute Chronic Hematoma and Chronic Subdural Hematoma with acute bleeding. From the collected cases, various demographic characteristics, clinical and pharmacological background, radiological, surgical, follow-up and prognostic features were defined, and a statistical analysis was performed to look for significant variables. A total of 281 patients were analyzed, after performing the statistical analysis (univariate and multivariate analysis) of the multiple variables of the population, statistically significant associations were found in relation to unfavourable GOS at 12 months for the following sections: age, Glasgow Coma Scale on admission, Glasgow Outcome Scale on admission, midline deviation, use of anticoagulant and antiplatelet treatment and intrahematoma septae. Chronic subdural hematomas, in a high percentage, are subsidiary of surgical treatment. There are several factors that negatively influence the prognosis in patients and that should be considered for both the surgical decision and patient/family agreement and for the medium/long-term follow-up of them. |
| ArticleNumber | 100606 |
| Author | Galárraga Campoverde, Raúl Alejandro Conde Alonso, Cesáreo Miguel Thenier-Villa, José Luis González-Vargas, Pedro Miguel Martín-Gallego, Álvaro de la Lama Zaragoza, Adolfo Calero Félix, Lourdes |
| Author_xml | – sequence: 1 givenname: Pedro Miguel surname: González-Vargas fullname: González-Vargas, Pedro Miguel email: pedro.miguel.gonzalez.vargas@sergas.es organization: Deparment of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain – sequence: 2 givenname: José Luis surname: Thenier-Villa fullname: Thenier-Villa, José Luis email: jose.luis.thenier.villa@sergas.es organization: Department of Neurosurgery, Hospital Universitari Arnau de Vilanova, Lleida, Spain – sequence: 3 givenname: Lourdes surname: Calero Félix fullname: Calero Félix, Lourdes email: lourdes.calero.felix@sergas.es organization: Deparment of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain – sequence: 4 givenname: Raúl Alejandro surname: Galárraga Campoverde fullname: Galárraga Campoverde, Raúl Alejandro email: raul.alejandro.galarraga.campoverde@sergas.es organization: Deparment of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain – sequence: 5 givenname: Álvaro surname: Martín-Gallego fullname: Martín-Gallego, Álvaro email: alvaro.martin.gallego@sergas.es organization: Deparment of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain – sequence: 6 givenname: Adolfo surname: de la Lama Zaragoza fullname: de la Lama Zaragoza, Adolfo email: adolfo.ramon.de.la.lama.zaragoza@sergas.es organization: Deparment of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain – sequence: 7 givenname: Cesáreo Miguel surname: Conde Alonso fullname: Conde Alonso, Cesáreo Miguel email: cesareo.miguel.conde.alonso@sergas.es organization: Deparment of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain |
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