Incidence, therapy, and outcome in the management of chronic subdural hematoma in Switzerland: a population-based multicenter cohort study

作者：Amir El Rahal, Jürgen Beck, Peter Ahlborn, Corrado Bernasconi, Serge Marbacher, Stefan Wanderer, Jan‐Karl Burkhardt, Roy Thomas Daniel, Andrea C. Ferrari, Oliver Nic Hausmann, Maria Kamenova, Karl Friedrich Kothbauer, Katharina Lutz, Luigi Mariani, Alex Alfieri, Daniel Schöni, Philippe Schucht, Andreas Raabe, Luca Regli, Dominique Kuhlen, Martin Alexander Seule, Jehuda Soleman, Daniele Starnoni, Julien Zaldivar, Christian Zweifel, Karl Schaller, Christian Fung · 发表于：Frontiers in Neurology · 年份：2023 · DOI：10.3389/fneur.2023.1206996 · 被引用次数：41 · 研究领域：Neurosurgical Procedures and Complications、Traumatic Brain Injury and Neurovascular Disturbances、Intracerebral and Subarachnoid Hemorrhage Research

Background Chronic subdural hematoma (cSDH) is a disease affecting mainly elderly individuals. The reported incidence ranges from 2.0/100,000 to 58 per 100,000 person-years when only considering patients who are over 70 years old, with an overall incidence of 8.2–14.0 per 100,000 persons. Due to an estimated doubling of the population above 65 years old between 2000 and 2030, cSDH will become an even more significant concern. To gain an overview of cSDH hospital admission rates, treatment, and outcome, we performed this multicenter national cohort study of patients requiring surgical treatment of cSDH. Methods A multicenter cohort study included patients treated in 2013 in a Swiss center accredited for residency. Demographics, medical history, symptoms, and medication were recorded. Imaging at admission was evaluated, and therapy was divided into burr hole craniostomy (BHC), twist drill craniostomy (TDC), and craniotomy. Patients' outcomes were dichotomized into good (mRS, 0–3) and poor (mRS, 4–6) outcomes. A two-sided t -test for unpaired variables was performed, while a chi-square test was performed for categorical variables, and a p -value of <0.05 was considered to be statistically significant. Results A total of 663 patients were included. The median age was 76 years, and the overall incidence rate was 8.2/100,000. With age, the incidence rate increased to 64.2/100,000 in patients aged 80–89 years. The most prevalent symptoms were gait disturbance in 362 (58.6%) of patie...