Effect of Different Factors on the Short-Term Outcome of Chinese Patients With Primary Chronic Subdural Hematoma at Different Age Groups: A Two-Center Retrospective Study
Effect of Different Factors on the Short-Term Outcome of Chinese Patients With Primary Chronic Subdural Hematoma at Different Age Groups: A Two-Center Retrospective Study
复制标题
不同因素对中国不同年龄组原发性慢性硬膜下血肿患者短期预后的影响：两中心回顾性研究
DOI：
10.3389/fnagi.2019.00325
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发表时间：
2019-11-29
影响因子：
4.8
通讯作者：
Jiang, Rongcai
中科院分区：
文献类型：
--
作者：
Huang, Jinhao;Tian, Ye;Jiang, Rongcai
背景中国老年人群中症状性慢性硬膜下血肿（CSDH）的发病率日益增加，但对其临床和人口学知识仍缺乏。本研究旨在概述来自天津和重庆两个医疗中心的CSDH患者的临床和人口统计学数据，以更好地了解中国的CSDH治疗。方法记录入选患者的年龄、性别、病因、入院时的意识水平、治疗策略、出院时的转归、复发情况及伴随疾病。将患者分为年轻/中年（小于60岁）和老年（大于60岁）年龄组后，进一步分析数据。结果共纳入1281例慢性硬膜下血肿患者。其中，85.01%为男性，51.91%年龄在60至80岁之间。57.61%的患者在诊断CSDH前有过头部外伤史。入院时临床症状前三位分别为头痛（58.55%）、运动障碍（36.92%）和头晕（33.96%）。头痛、头晕多见于中青年组，运动障碍多见于老年组。最常见的合并症是心脑血管系统疾病（41.14%）。老年患者合并呼吸系统疾病导致不良结局（p = 0.049，OR：0.357）。保守治疗的老年亚组预后明显好于钻孔引流治疗的老年亚组（P < 0.015，OR：4.091）。结论慢性硬膜下血肿好发于有颅脑外伤史的老年男性.呼吸系统疾病常导致老年患者的不良结局。保守治疗可能对某些患者有益。
Background The incidence of symptomatic chronic subdural hematoma (CSDH) is increasing in Chinese aging population, but its clinical and demographic knowledge is still lacking. This study sought to outline the clinical and demographic data of CSDH patients from two medical centers in Tianjin and Chongqing to provide a better understanding for CSDH treatment in China. Methods Age, sex, etiologies, conscious level on admission, treatment strategies, outcome at discharge, recurrence, and concomitant disease of enrolled patients were recorded. The data were further analyzed after the patients were sub-grouped into young/middle (less than 60 years old) and old (over than 60 years old) age groups. Results A total of 1281 CSDH patients were enrolled. Of these, 85.01% were male and 51.91% were aged between 60 and 80 years. 57.61% patients encountered head trauma before diagnosing CSDH. The top three clinical symptoms at admission were headache (58.55%), dyskinesia (36.92%), and dizziness (33.96%). Headache as well as dizziness often happened in young/middle age group, while dyskinesia often occurred in the old age group. The most common concomitant diseases were cardio-cerebrovascular system diseases (41.14%). The concomitant respiratory diseases in aged patients led to unfavorable outcomes (p = 0.049, OR:0.357). The prognosis of old age subgroup receiving conservative treatment was better than those who received burr-hole drainage treatment (p < 0.015, OR:4.091). Conclusion CSDH mostly occurs in aged and male population with a history a head trauma. The respiratory disease often results in unfavorable outcomes in aged patients. Conservative treatment might benefit some patients.