Analysis Of Atypical Symptoms And Related Factors Of Chronic Subdural Hematoma

Objectives: To analyze the related factors of atypical symptoms of chronic subdural hematoma,so as to provide reference for timely diagnosis and treatment,so as to reduce the delay of diagnosis and treatment and improve the quality of life of patients.Methods:(1)The clinical symptoms,gender and age of 978 patients with chronic subdural hematoma who were hospitalized in the First People’s Hospital of Yunnan Province from January 2005 to January 2020 were retrospectively collected,and the occurrence of atypical symptoms of chronic subdural hematoma was analyzed.(2)105cases of chronic subdural hematoma with atypical symptoms and complete data were selected as the study group(typical symptoms group),105 cases of 853 cases of chronic subdural hematoma with typical symptoms were selected as the control group(atypical symptoms group)according to random data method,and their clinical data were collected(including: Visit symptoms,gender,age,time from symptom onset to visit(days)),personal history(including drinking history,trauma history,smoking history),comorbidities(including hypertension,diabetes,coronary heart disease,and cerebral infarction),laboratory data(including: Blood routine,liver and kidney function,glucose,electrolyte,lipid,coagulation function),imaging data,and volume of interest(VOI)free volume measurement software was used to calculate the amount of blood loss.(3)The correlation factors of atypical symptoms of chronic subdural hematoma were investigated by univariate analysis.Multivariate binary Logistic regression model was used to screen the independent influencing factors of atypical symptoms of chronic subdural hematoma.Results:1.General information of 978 patients with chronic subdural hematoma:(1)The distribution of symptoms includes: There were 459 cases(46.9%)of headache,161cases(16.5%)of dizziness/fainting,153 cases(15.6%)of physical disturbance,74cases(7.6%)of loss of consciousness,6 cases(0.6%)of nausea/vomiting,8 cases(0.8%)of lethargy,27 cases(2.8%)of speech disturbance,1 case(0.1%)of eye pain,and body shaking/convulsion Eyelid/incontinence in 14 cases(1.4%),memory loss in6 cases(0.6%),slow movement in 24 cases(2.5%),sleepiness in 2 cases(0.2%),chill phobia in 2 cases(0.2%),blurred vision in 2 cases(0.2%),visual acuity in 1 case(0.1%),amaurosis in 1 case(0.1%),poor sleep in 3 cases(0.3%),no special symptoms34 cases(3.5%).(2)Incidence of atypical symptoms: Among 978 patients with chronic subdural hematoma,a total of 853 patients(87.2%)showed typical symptoms of chronic subdural hematoma and 125 patients(12.8%)showed atypical symptoms of chronic subdural hematoma.(3)Gender: There were 978 patients with chronic subdural hematoma,including 807 males(82.5%)and 171 females(17.5%).There were 703 males(82.4%)and 150 females(17.6%)in chronic subdural hematoma with typical symptoms.Among the patients with chronic subdural hematoma presenting atypical symptoms,104(83.2%)were males and 21(16.8%)were females.(4)Age:Among 978 patients with chronic subdural hematoma,the age distribution ranged from 0.1 to 97 years old,142 cases(14.5%)≤44 years old;There were 235 cases(24.0%)aged 45 years ≤X≤59 years;333 cases(34.1%)aged 60 ≤X≤74 years;268cases(27.4%)were ≥75 years old;The median age of those presenting with typical symptoms was 64.0 years,and the median age of those presenting with atypical symptoms was 72.0 years.2.Related factors of atypical symptoms of chronic subdural hematoma:(1)Symptom distribution: There were 105 cases(50.0%)in the typical symptom group,including headache in 50 cases(23.8%),dizziness/dizziness in 24 cases(11.4%),limb movement disorder in 21 cases(10.0%),loss of consciousness in 10 cases(4.8%);A total of 105 patients(50.0%)in the atypical symptom group had the following symptoms: 8 cases(3.8%),23 cases(10.9%)of speech disorders,1 case(0.5%)of eye pain,10 cases(4.8%)of body shaking/convulsion/incontinence,6 cases(2.8%)of memory loss,15 cases(7.1%)of slow movement,2 cases(1.0%)of sleepiness,2cases(1.0%)of chilliness,2 cases(1.0%)of blurred vision),visual acuity decreased in 1 case(0.5%),amaurosis in 1 case(0.5%),poor sleep in 3 cases(1.4%),and no special symptoms in 31 cases(14.7%).(2)Age,time from symptom onset to medical visit(days),history of alcohol consumption,history of trauma,history of diabetes,globulin,sodium ions,high-density lipoprotein cholesterol,low density lipoprotein cholesterol,and complicated occipital hemorrhage were statistically different in the atypical symptom group compared with the typical symptom group(p < 0.05).(3)Atypical symptoms group gender,smoking history,hypertension history,coronary heart disease history,cerebral infarction history,blood loss,white blood cells,red blood cells,hemoglobin,platelets,glutamic oxalic aminotransferase,alanine aminotransferase,total bilirubin,direct bilirubin,indirect bilirubin,total protein,albumin,urea nitrogen,creatinine,uric acid,chloride ion,potassium ion,calcium ion,bicarbonate,partial coagulation The active enzyme time,prothrombin time,international normalized ratio,fibrinogen,thrombin time,total cholesterol,triglyceride and glucose showed no statistical difference compared with the typical symptom group(p > 0.05).3.Logistic regression analysis:(1)Age is an independent risk factor for atypical symptoms in patients with chronic subdural hematoma,and for patients with chronic subdural hematoma,the older the age,the greater the probability of atypical symptoms(OR=1.041,95%CI: 1.010-1.073,p=0.009).(2)A history of alcohol consumption is an independent risk factor for atypical symptoms in patients with chronic subdural hematoma,and is more likely to present with atypical symptoms in patients with chronic subdural hematoma(OR=4.097,95%CI: 1.587-10.576,p=0.004).Conclusions:1.The incidence of atypical symptoms in chronic subdural hematoma patients was 12.8%;2.Age,time between symptom onset and medical visit,history of alcohol consumption,history of trauma,history of diabetes,globulin,sodium ions,highdensity lipoprotein cholesterol,low density lipoprotein cholesterol,and concomitant occipital hemorrhage were associated with atypical symptoms in patients with chronic subdural hematoma(p < 0.05).3.Age and drinking history are independent risk factors of atypical symptoms in chronic subdural hematoma patients.