Publication

Neurosurgical and Perioperative Management of Chronic Subdural Hematoma

Blaauw, J., Jacobs, B., den Hertog, H. M., van der Gaag, N. A., Jellema, K., Dammers, R., Lingsma, H. F., van der Naalt, J., Kho, K. H. & Groen, R. J. M., 19-Jun-2020, In : Frontiers in Neurology. 11, 8 p., 550.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Blaauw, J., Jacobs, B., den Hertog, H. M., van der Gaag, N. A., Jellema, K., Dammers, R., Lingsma, H. F., van der Naalt, J., Kho, K. H., & Groen, R. J. M. (2020). Neurosurgical and Perioperative Management of Chronic Subdural Hematoma. Frontiers in Neurology, 11, [550]. https://doi.org/10.3389/fneur.2020.00550

Author

Blaauw, Jurre ; Jacobs, Bram ; den Hertog, Heleen M ; van der Gaag, Niels A ; Jellema, Korné ; Dammers, Ruben ; Lingsma, Hester F ; van der Naalt, Joukje ; Kho, Kuan H ; Groen, Rob J M. / Neurosurgical and Perioperative Management of Chronic Subdural Hematoma. In: Frontiers in Neurology. 2020 ; Vol. 11.

Harvard

Blaauw, J, Jacobs, B, den Hertog, HM, van der Gaag, NA, Jellema, K, Dammers, R, Lingsma, HF, van der Naalt, J, Kho, KH & Groen, RJM 2020, 'Neurosurgical and Perioperative Management of Chronic Subdural Hematoma', Frontiers in Neurology, vol. 11, 550. https://doi.org/10.3389/fneur.2020.00550

Standard

Neurosurgical and Perioperative Management of Chronic Subdural Hematoma. / Blaauw, Jurre; Jacobs, Bram; den Hertog, Heleen M; van der Gaag, Niels A; Jellema, Korné; Dammers, Ruben; Lingsma, Hester F; van der Naalt, Joukje; Kho, Kuan H; Groen, Rob J M.

In: Frontiers in Neurology, Vol. 11, 550, 19.06.2020.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Blaauw J, Jacobs B, den Hertog HM, van der Gaag NA, Jellema K, Dammers R et al. Neurosurgical and Perioperative Management of Chronic Subdural Hematoma. Frontiers in Neurology. 2020 Jun 19;11. 550. https://doi.org/10.3389/fneur.2020.00550


BibTeX

@article{8664b7ed6a574aca91fdcb5edc323254,
title = "Neurosurgical and Perioperative Management of Chronic Subdural Hematoma",
abstract = "Objective:Surgery and specifically burr hole craniostomy is the most common first choice treatment of patients with Chronic Subdural Hematoma (CSDH). However, several aspects of neurosurgical and peri-operative management are still a subject of research, such as how to treat bilateral CSDH and the anesthetic approach. We aim to investigate the effect of the surgical approach to bilateral CSDH and the effect of anesthesia modality on outcome of CSDH patients. Methods:We retrospectively included surgically treated CSDH patients between 2005 and 2019 in three hospitals in the Netherlands. The effect of the surgical approach to bilateral CSDH (unilateral vs. bilateral decompression) and anesthesia modality (general vs. local anesthesia) on outcome (complications, recurrence, and length of hospital stay over 4 days) was studied with logistic regression adjusting for potentially confounding radiological and clinical characteristics. Results:Data of 1,029 consecutive patients were analyzed, mean age was 73.5 years (+/- 11) and 75% of patients were male. Bilateral CSDH is independently associated with an increased risk of recurrence within 3 months in logistic regression analysis (aOR 1.7, 95% CI: 1.1-2.5) but recurrence rate did not differ between primary bilateral or unilateral decompression of bilateral CSDH. (15 vs. 17%,p= 0.775). Logistic regression analysis showed that general anesthesia was independently associated with an increased risk of complications (aOR 1.8, 95% CI: 1.0-3.3) and with a length of hospital admission of over 4 days (aOR 8.4, 95% CI: 5.6-12.4). Conclusions:Bilateral CSDH is independently associated with higher recurrence rates. As recurrence rates in bilateral CSDH are similar for different surgical approaches, the optimal choice for primary bilateral decompression of bilateral CSDH could vary per patient. General anesthesia for surgical treatment of CSDH is associated with higher complication rates and longer hospital admission.",
keywords = "chronic subdural hematoma, neurosurgery, anesthesia, bilateral chronic subdural hematoma, logistic regression, LOCAL-ANESTHESIA, GENERAL-ANESTHESIA, ELDERLY-PATIENTS, RISK-FACTORS, SURGERY, RECURRENCE",
author = "Jurre Blaauw and Bram Jacobs and {den Hertog}, {Heleen M} and {van der Gaag}, {Niels A} and Korn{\'e} Jellema and Ruben Dammers and Lingsma, {Hester F} and {van der Naalt}, Joukje and Kho, {Kuan H} and Groen, {Rob J M}",
note = "Copyright {\textcopyright} 2020 Blaauw, Jacobs, den Hertog, van der Gaag, Jellema, Dammers, Lingsma, Naalt, Kho and Groen.",
year = "2020",
month = jun,
day = "19",
doi = "10.3389/fneur.2020.00550",
language = "English",
volume = "11",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Media SA",

}

RIS

TY - JOUR

T1 - Neurosurgical and Perioperative Management of Chronic Subdural Hematoma

AU - Blaauw, Jurre

AU - Jacobs, Bram

AU - den Hertog, Heleen M

AU - van der Gaag, Niels A

AU - Jellema, Korné

AU - Dammers, Ruben

AU - Lingsma, Hester F

AU - van der Naalt, Joukje

AU - Kho, Kuan H

AU - Groen, Rob J M

N1 - Copyright © 2020 Blaauw, Jacobs, den Hertog, van der Gaag, Jellema, Dammers, Lingsma, Naalt, Kho and Groen.

PY - 2020/6/19

Y1 - 2020/6/19

N2 - Objective:Surgery and specifically burr hole craniostomy is the most common first choice treatment of patients with Chronic Subdural Hematoma (CSDH). However, several aspects of neurosurgical and peri-operative management are still a subject of research, such as how to treat bilateral CSDH and the anesthetic approach. We aim to investigate the effect of the surgical approach to bilateral CSDH and the effect of anesthesia modality on outcome of CSDH patients. Methods:We retrospectively included surgically treated CSDH patients between 2005 and 2019 in three hospitals in the Netherlands. The effect of the surgical approach to bilateral CSDH (unilateral vs. bilateral decompression) and anesthesia modality (general vs. local anesthesia) on outcome (complications, recurrence, and length of hospital stay over 4 days) was studied with logistic regression adjusting for potentially confounding radiological and clinical characteristics. Results:Data of 1,029 consecutive patients were analyzed, mean age was 73.5 years (+/- 11) and 75% of patients were male. Bilateral CSDH is independently associated with an increased risk of recurrence within 3 months in logistic regression analysis (aOR 1.7, 95% CI: 1.1-2.5) but recurrence rate did not differ between primary bilateral or unilateral decompression of bilateral CSDH. (15 vs. 17%,p= 0.775). Logistic regression analysis showed that general anesthesia was independently associated with an increased risk of complications (aOR 1.8, 95% CI: 1.0-3.3) and with a length of hospital admission of over 4 days (aOR 8.4, 95% CI: 5.6-12.4). Conclusions:Bilateral CSDH is independently associated with higher recurrence rates. As recurrence rates in bilateral CSDH are similar for different surgical approaches, the optimal choice for primary bilateral decompression of bilateral CSDH could vary per patient. General anesthesia for surgical treatment of CSDH is associated with higher complication rates and longer hospital admission.

AB - Objective:Surgery and specifically burr hole craniostomy is the most common first choice treatment of patients with Chronic Subdural Hematoma (CSDH). However, several aspects of neurosurgical and peri-operative management are still a subject of research, such as how to treat bilateral CSDH and the anesthetic approach. We aim to investigate the effect of the surgical approach to bilateral CSDH and the effect of anesthesia modality on outcome of CSDH patients. Methods:We retrospectively included surgically treated CSDH patients between 2005 and 2019 in three hospitals in the Netherlands. The effect of the surgical approach to bilateral CSDH (unilateral vs. bilateral decompression) and anesthesia modality (general vs. local anesthesia) on outcome (complications, recurrence, and length of hospital stay over 4 days) was studied with logistic regression adjusting for potentially confounding radiological and clinical characteristics. Results:Data of 1,029 consecutive patients were analyzed, mean age was 73.5 years (+/- 11) and 75% of patients were male. Bilateral CSDH is independently associated with an increased risk of recurrence within 3 months in logistic regression analysis (aOR 1.7, 95% CI: 1.1-2.5) but recurrence rate did not differ between primary bilateral or unilateral decompression of bilateral CSDH. (15 vs. 17%,p= 0.775). Logistic regression analysis showed that general anesthesia was independently associated with an increased risk of complications (aOR 1.8, 95% CI: 1.0-3.3) and with a length of hospital admission of over 4 days (aOR 8.4, 95% CI: 5.6-12.4). Conclusions:Bilateral CSDH is independently associated with higher recurrence rates. As recurrence rates in bilateral CSDH are similar for different surgical approaches, the optimal choice for primary bilateral decompression of bilateral CSDH could vary per patient. General anesthesia for surgical treatment of CSDH is associated with higher complication rates and longer hospital admission.

KW - chronic subdural hematoma

KW - neurosurgery

KW - anesthesia

KW - bilateral chronic subdural hematoma

KW - logistic regression

KW - LOCAL-ANESTHESIA

KW - GENERAL-ANESTHESIA

KW - ELDERLY-PATIENTS

KW - RISK-FACTORS

KW - SURGERY

KW - RECURRENCE

U2 - 10.3389/fneur.2020.00550

DO - 10.3389/fneur.2020.00550

M3 - Article

C2 - 32636797

VL - 11

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 550

ER -

ID: 129189235