Trauma Mechanisms and Surgical Outcomes in the Elderly Patient with Chronic Subdural Hematoma

Authors

  • Jimmy Sundblom Uppsala University Hospital
  • Elisabeth Sandberg Uppsala University Hospital; Karolinska University Hospital
  • Elisabeth Ronne-Engström Uppsala University Hospital

DOI:

https://doi.org/10.5770/cgj.25.519

Keywords:

chronic subdural hematoma, fall injuries, surgery, mortality, recurrence

Abstract

Background 

Chronic subdural hematoma is the preeminent neurosurgical condition in the older population. This retrospective single-centre study focuses on outcome after surgery of chronic subdural hematoma in patients over 70 years. 

Methods 

Patients treated at a single neurosurgical referral centre between 2010 and 2014 were screened. Included patients were assessed for comorbid conditions, lifestyle factors, and outcomes including recurrence, mortality, and postoperative complications. 

Results 

A total of 511 patients (70–97 yrs) were identified. 50.7% of patients were treated with anticoagulants and/or antiplatelet therapy. A known probable cause for the hematoma was found in 68.1% of patient’s histories. Mortality rate was 3.1% and recurrence was seen in 49 patients (9.6%). Postoperative complications were more common in patients with excessive use of alcohol (p value = .02). Neurological function was improved in 78.1% of patients after the initial surgery. A strategy of delayed contralateral surgery in bilateral hematomas showed low rates of recurrence. 

Conclusion 

Fall injuries are the most common underlying trauma mechanism in the elderly with chronic subdural hematoma. Recurrence is not more common in the elderly patient group compared to the general population. Excessive alcohol use is a risk factor for post-operative complications. 

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Published

2022-03-02

How to Cite

1.
Sundblom J, Sandberg E, Ronne-Engström E. Trauma Mechanisms and Surgical Outcomes in the Elderly Patient with Chronic Subdural Hematoma. Can Geriatr J [Internet]. 2022 Mar. 2 [cited 2022 Sep. 25];25(1):40-8. Available from: https://cgjonline.ca/index.php/cgj/article/view/519

Issue

Section

Original Research