INDEPENDENT PREDICTORS FOR RECURRENCE OF CHRONIC SUBDURAL HEMATOMA: A REVIEW OF 343 CONSECUTIVE SURGICAL CASES
INDEPENDENT PREDICTORS FOR RECURRENCE OF CHRONIC SUBDURAL HEMATOMA: A REVIEW OF 343 CONSECUTIVE SURGICAL CASES
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DOI：
10.1227/01.neu.0000335782.60059.17
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发表时间：
2008-12-01
期刊：
影响因子：
4.8
通讯作者：
Yamagata, Sen
中科院分区：
文献类型：
--
作者：
Torihashi, Kouichi;Sadamasa, Nobutake;Yamagata, Sen
目的：慢性硬膜下血肿(CSDH)是一种常见的颅内出血形式，复发率高。我们专注于确定与慢性硬膜下血肿复发相关的独立预测因素。方法：我们回顾了连续343例慢性硬膜下血肿手术病例。单因素和多因素分析显示性别、年龄、高血压、糖尿病、心脏病、脑血管疾病、心房颤动、抗血小板或抗凝治疗、双侧慢性硬膜下血肿复发与慢性硬膜下血肿复发的关系。单因素和多因素分析发现，双侧CSDH是CSDH复发的独立危险因素。尽管抗血小板和/或抗凝治疗对CSDH的复发无显著影响，但接受抗血小板和/或抗凝治疗的患者从损伤到首次手术的时间间隔比未接受抗血小板和/或抗凝治疗的患者短(29.9天比44.2天)。结论：双侧CSDH是CSDH复发的独立预测因素。抗血小板或抗凝血药物可促进CSDH的生长。这些结果可能有助于识别CSDH复发的高危患者。
OBJECTIVE: Chronic subdural hematoma (CSDH) is a common form of intracranial hemorrhage with a substantial recurrence rate. We focused on determining independent predictors associated with the recurrence of CSDH.METHODS: We retrospectively reviewed 343 consecutive Surgical cases of CSDH. Univariate and multivariate analyses were performed to describe the relationships between recurrence of CSDH and factors such as sex, age, hypertension, diabetes mellitus, heart disease, cerebrovascular disease, atrial fibrillation, antiplatelet or anticoagulant therapy, and bilateral CSDH.RESULTS: Sixty-one patients experienced a recurrence of CSDH. Univariate and multivariate analyses found that bilateral CSDH was an independent risk factor for the recurrence of CSDH. Although antiplatelet and anticoagulant therapy had no significant effect on recurrence of CSDH, the time interval between the injury and the first operation for patients with antiplatelet and/or anticoagulant therapy was shorter than that for patients without it (29.9 versus 44.2 days),CONCLUSION: Bilateral CSDH was an independent predictor for the recurrence of CSDH. Antiplatelet or anticoagulant drugs might facilitate the growth of CSDH. These results may help to identify patients at high risk for the recurrence of CSDH.