Predictive Factors for Recurrence after Burr-Hole Craniostomy of Chronic Subdural Hematoma

ABSTRACT

OBJECTIVE: Chronic subdural hematoma is a common and relatively benign disease. However, recurrence is common after surgical treatment, and the recurrence rate varies from 5% to 33%. The aim of this study was to investigate the predictive factors for recurrence of chronic subdural hematoma. METHODS: We analyzed data from 248 patients with chronic subdural hematoma who were treated by burr-hole craniostomy with a closed drainage system for hematoma evacuation in this five-year retrospective study. RESULTS: Thirty-one (12.6%) patients underwent re-operation for recurrence of chronic subdural hematoma. Univariate analysis revealed that anticoagulation (p=0.0279), headache (p=0.0323), and preoperative midline shifting (p=0.0321) showed significant differences with respect to recurrent chronic subdural hematoma. We performed a multivariate logistic regression analysis and found that diabetes mellitus (odds ratio [OR], 2.618; 95% confidence interval [CI], 1.0899–6.2898; p=0.0314), anticoagulation (OR, 6.739; 95% CI, 1.1287–40.2369; p=0.0364), headache (OR, 2.951; 95% CI, 1.1464–7.5964; p=0.0249), and preoperative midline shifting (OR, 1.0838; 95% CI, 1.0040–1.1699; p=0.0391) were independent predictive factors for recurrence of chronic subdural hematoma. CONCLUSION: We showed that diabetes mellitus, anticoagulation, headache, and preoperative midline shifting were independent predictors of recurrence of chronic subdural hematoma.