Predictors of acute intracranial hemorrhage and recurrence of chronic subdural hematoma following burr hole drainage
Predictors of acute intracranial hemorrhage and recurrence of chronic subdural hematoma following burr hole drainage
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DOI：
10.1186/s12883-020-01669-5
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发表时间：
2020-03-13
期刊：
影响因子：
2.6
通讯作者：
Yang, Xiao Feng
中科院分区：
文献类型：
--
作者：
Chen, Fu Mei;Wang, Ke;Yang, Xiao Feng
目的探讨慢性硬膜下血肿（CSDH）钻孔引流术后急性颅内出血（AIH）和复发的预测因素。方法对2013年1月至2019年3月期间接受CSDH钻孔引流的患者进行多中心回顾性研究。CSDH复发60例，复发率13.4%。首次钻孔引流至复发的平均时间为40.828.3天。术后发生AIH 23例，发生率为5.1%。初始钻孔引流与术后AIH之间的平均时间间隔为4.7 ± 2.9天。在多因素Logistic回归分析中，双侧血肿、高密度血肿和抗凝药物使用是复发的独立预测因素。多元Logistic回归分析显示，术前头痛是术后AIH的独立危险因素，术中冲洗可降低术后AIH的发生率。结论双侧血肿、高密度血肿和抗凝药物使用与CSDH复发独立相关。头痛的临床表现是术后AIH的最强预测因素，术中冲洗可降低术后AIH的发生率。
BackgroundTo investigate predictors of postoperative acute intracranial hemorrhage (AIH) and recurrence of chronic subdural hematoma (CSDH) after burr hole drainage.MethodsA multicenter retrospective study of patients who underwent burr hole drainage for CSDH between January 2013 and March 2019.ResultsA total of 448 CSDH patients were enrolled in the study. CSDH recurrence occurred in 60 patients, with a recurrence rate of 13.4%. The mean time interval between initial burr hole drainage and recurrence was 40.828.3days. Postoperative AIH developed in 23 patients, with an incidence of 5.1%. The mean time interval between initial burr hole drainage and postoperative AIH was 4.7 +/- 2.9days. Bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independent predictors of recurrence in the multiple logistic regression analyses. Preoperative headache was an independent risk factor of postoperative AIH in the multiple logistic regression analyses, however, intraoperative irrigation reduced the incidence of postoperative AIH.Conclusions p id=Par This study found that bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independently associated with CSDH recurrence. Clinical presentation of headache was the strongest predictor of postoperative AIH, and intraoperative irrigation decreased the incidence of postoperative AIH.