Risk Factors Affecting The Recurrence Of Chronic Subdural Hematoma And Prevention And Control Strategies

Objective: To investigate the risk factors affecting the recurrence of chronic subdural hematoma for evidence to scientifically plan treatment strategies and evaluate the prognosis for this clinical entity.Methods: Clinical data were reviewed in 247 cases of chronic subdural hematoma treated in our department between April 2014 and December 2016.Univariate analysis and multivariate logistic regression analysis were performed to evaluate the risk factors affecting recurrence of the hematoma.Results:No postoperative recurrence in 232 cases(not relapse group),15 cases of postoperative recurrence(recurrence),recurrence rate was 6.07%.Two groups of patients with single factor analysis showed that the degree of preoperative midline shift,preoperative CT density,postoperative residual pneumatosis,fluid volume and postoperative induced flow difference has statistical significance(P <0.05).Multiariable Logistic regression analysis preoperative midline shift odds ratio >10 mm(odds ratio,OR)and 95% confidence interval(the confidence interval,CI)(OR= 11.293,95% CI: 1.954-65.264,p = 0.007),preoperative hematoma CT performance for high density OR mixed density(OR = 4.934,95% CI: 1.114-21.847,p = 0.036),postoperative residual a large number of pneumatosis(OR = 4.173,95% CI:1.765-9.869,p = 0.001),postoperative drainage > 200 ml(OR = 3.359,95% CI:1.300-8.680,p = 0.012)four factors significantly related with CSDH drilling drainage postoperative recurrence.Conclusion:Preoperative midline displacement,hematoma density,postoperative air accumulation and postoperative drainage were independent risk factors for recurrence of chronic subdural hematoma.Detailed clinical analysis and radiographic evaluation before surgery as well as stringent postoperative monitoring can be of great significance for and improve prognosis of the chronic subdural hematoma.