Surgery for chronic subdural hematoma in nonagenarians: A Scandinavian population-based multicenter study

被引:35
作者
Bartek, J., Jr. [1 ,2 ,3 ]
Sjavik, K. [4 ]
Stahl, F. [1 ,2 ]
Kristiansson, H. [1 ,2 ]
Solheim, O. [5 ,6 ,7 ]
Gulati, S. [5 ,6 ]
Sagberg, L. M. [5 ,6 ,7 ]
Forander, P. [1 ,2 ]
Jakola, A. S. [5 ,8 ,9 ]
机构
[1] Karolinska Inst, Sect Neurosurg, Dept Clin Neurosci, Stockholm, Sweden
[2] Karolinska Univ Hosp, Dept Neurosurg, Stockholm, Sweden
[3] Copenhagen Univ Hosp, Dept Neurosurg, Rigshosp, Copenhagen, Denmark
[4] Univ Hosp North Norway, Dept Neurosurg, Tromso, Norway
[5] St Olavs Univ Hosp, Dept Neurosurg, Trondheim, Norway
[6] Norwegian Univ Sci & Technol, Dept Neurosci, Trondheim, Norway
[7] St Olav Hosp, Norwegian Natl Advisory Unit Ultrasound & Image G, Trondheim, Norway
[8] Sahlgrens Univ Hosp, Dept Neurosurg, Gothenburg, Sweden
[9] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Gothenburg, Sweden
来源
ACTA NEUROLOGICA SCANDINAVICA | 2017年 / 136卷 / 05期
关键词
chronic subdural hematoma; nonagenarians; old; outcome; surgery; RISK-FACTORS; COMPLICATIONS; MANAGEMENT; DRAINAGE;
D O I
10.1111/ane.12764
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Chronic subdural hematoma (cSDH) is a prevalent condition often seen in the elderly, with surgery being the treatment of choice when symptomatic. So far, few have explored the surgical outcomes in patients 90 years or older. The aim of this study was to investigate outcome after cSDH surgery in nonagenarians (>= 90 y/o group) compared to younger adult patients (< 90 y/o group). Materials: In a Scandinavian population-based cohort we conducted a retrospective review of 1,254 patients undergoing primary burr--hole procedures for cSDH between January 1, 2005 and December 31, 2010 at three neurosurgical centers. In a comparative analysis, the primary end-point was difference in hematoma recurrence rates between the >= 90 y/o and < 90 y/o groups. The secondary end-points were differences in perioperative morbidity and mortality between groups. Results: 75 patients were 90 years or older. There was no significant difference in recurrences resulting in reoperation between the age groups (10.7% vs 13.6%, P=. 47). There was also no significant difference in overall complication rate (4.1% vs 8.1%, P=. 21) or severe complications (1.4% vs 2.0%, P=. 68). There were three (4.0%) perioperative deaths within 30 days in the >= 90 y/o group and 40 (3.4%) in the < 90 y/o group (P=. 78). Conclusion: Patients 90 years or older had similar rates of recurrence, perioperative morbidity and perioperative mortality as compared to younger patients. Age alone should not be a contraindication for surgery in patients with cSDH.
引用
收藏
页码:516 / 520
页数:5
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