The Risk Factors For Recurrence Of Chronic Subdural Hematoma After Burr-hole And Drainage

Objective To sum up the risk factors of recurrence of chronic subdural hematoma (CSDH) after burr-hole and drainage.Methods A total of1013patients who underwent surgery for CSDH in our hospital from January2009to December2013were retrospectively analyzed. Twenty-three (2.3%) patients experienced at least one recurrence of chronic subdural hematoma during the study period. Twelve patients were chosen as the experimental group, and thirty-six patients were chosen as matched group. We analyzed the following factors: age, sex, injury history, medical history, prothrombin time, activated partial thromboplastin time, international normalized ratio, brain atrophy, unilateral or bilateral hematoma, hematoma laterality, internal architecture of the hematoma, hematoma thickness and degree of midline shift of the hematoma in the preoperative CT films, direction of the drainage tube, duration of drainage, amount of drainage, fluid infusion of the first day after surgery, haemostatic use after surgery. Univariate and multivariate logistic regression analysis were performed to assess the relationships among various variables and CSDH recurrence.Results Univariate analysis indicated that such factors as prolonged of prothrombin time, high density or mixed density hematoma, separated hematoma, degree of midline shift(>10mm) were positively correlated to CSDH recurrence. When multivariate logistic regression analysis were employed, only prolonged of prothrombin time and high density or mixed density hematoma were dependent risk fators associated with CSDH recurrence.Conclusions Prolonged of prothrombin time, high density or mixed density hematoma are the most powerful risk predictors for the recurrence of CSDH after burr-hole and drainage..