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Ewbank, Frederick; Durnford, Andrew; Akarca, Danyal; Sadek, Ahmed-Ramadan; Hempenstall, Jonathan
World neurosurgery, January 2021, 2021-Jan, 2021-01-00, 20210101, Letnik: 145Journal Article
Although chronic subdural hematomas (cSDH) are often treated surgically it remains plausible that invasive treatment in elderly patients may have a negative effect on survival. The aim of this study was to characterize survival following neurosurgical intervention for cSDH in a selected cohort aged >90 years and to identify prognostic factors that may inform clinical decision-making. In total, we identified a cohort of 548 consecutive patients who had undergone burr hole drainage for cSDH in a 5-year period between 2009–2013. Of these patients, 41 were aged >90 years. For each patient, information was gathered from local hospital records, general practice records, and the patients directly. Long-term survival was compared with actuarial data obtained from the National Life Tables. Overall mortality at the time of discharge was 2%. Mortality was 26.8% at 6 months, 36.8% at 1 year, and 47.9% at 2 years. Interestingly, there was no significant difference between the actuarial curve and the survival curve following surgery (hazard ratio, 1.17; confidence interval, 0.67–2.05; P = 0.57). Despite initially departing from the actuarial curve, the survival curve becomes parallel at approximately 1 year. Multivariate analysis showed that preadmission residence and the number of comorbid conditions were significant predictors of survival. We advocate that neurosurgical intervention for cSDH in selected nonagenarians can be a safe and beneficial procedure. Patients living independently at home and with a limited past medical history were most likely to benefit from the surgery.
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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