Early Mobilization in Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis

作者：Usama AlDallal, Munashe Veremu, Sean O’Leary, William H. Cook, Youssef Chedid, Alex E. Henney, Mohammad Ashraf, David Quist, Vian Omar, Adele Mazzoleni, Jamie Brannigan, Matthew Watson, Keng Siang Lee, Orla Mantle, Githmi Palahepitiya Gamage, Alvaro Yanez Touzet, Gideon Adegboyega, Edward Goacher, Oliver Mowforth, Conor S. Gillespie, Daniel J. Stubbs, Benjamin M. Davies · 发表于：World Neurosurgery · 年份：2025 · DOI：10.1016/j.wneu.2025.124546 · 被引用次数：2 · 研究领域：Neurosurgical Procedures and Complications、Traumatic Brain Injury and Neurovascular Disturbances、Spinal Hematomas and Complications

BACKGROUND: There is variation in timing of postoperative mobilization in patients with chronic subdural hematoma (cSDH). Some studies suggest that early postoperative mobilization may reduce complications, without increase in recurrence. This review aims to evaluate whether timing of postoperative mobilization impacts such outcomes. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses-adherent systematic review and meta-analysis. Full-text articles comparing early mobilization (EM) and elevated head position against conventional methods were included. Search string developed to identify studies reporting on surgical treatment of cSDH was applied to MEDLINE and Embase databases (search date April 30, 2022, updated December 1, 2023). The primary outcome was complications (in-hospital, infection, and thromboembolic disease) and recurrence. Risk of bias was assessed using the Newcastle Ottowa Scale and Cochrane Risk of Bias 2 tool. RESULTS: = 0%). Head position did not affect complications (3 studies, OR: 0.71, 95% CI: 0.02-29.62), or recurrence rates (2 studies, OR: 1.35, 95% CI: 0.63-2.66). Mortality was intended as a secondary outcome but could not be analyzed due to insufficient data. Almost all studies scored as high risk of bias on assessment. CONCLUSIONS: EM decreases complications after cSDH, but is not associated with higher risk of recurrence. Additional prospective studies are required to further characterize this potential association, with gre...