J 2020

Reoperations after surgery for acute subdural hematoma: reasons, risk factors, and effects

CHRASTINA, Jan, Čeněk ŠILAR, Tomáš ZEMAN, Michal SVOBODA, Jan KRAJSA et. al.

Základní údaje

Originální název

Reoperations after surgery for acute subdural hematoma: reasons, risk factors, and effects

Autoři

CHRASTINA, Jan (203 Česká republika, garant, domácí), Čeněk ŠILAR (203 Česká republika, domácí), Tomáš ZEMAN (203 Česká republika, domácí), Michal SVOBODA (203 Česká republika, domácí), Jan KRAJSA (203 Česká republika, domácí), Barbora MUSILOVÁ (203 Česká republika, domácí) a Zdeněk NOVÁK (203 Česká republika, domácí)

Vydání

European Journal of Trauma and Emergency Surgery, HEIDELBERG, SPRINGER HEIDELBERG, 2020, 1863-9933

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Německo

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.693

Kód RIV

RIV/00216224:14110/20:00115103

Organizační jednotka

Lékařská fakulta

UT WoS

000522839100012

Klíčová slova anglicky

Brain injury; Acute subdural hematoma; Reoperation; Contralateral subdural hematoma; Decompressive craniectomy

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 17. 7. 2020 07:14, Mgr. Tereza Miškechová

Anotace

V originále

Purpose To analyze the reasons and patient-related and injury-related risk factors for reoperation after surgery for acute subdural hematoma (SDH) and the effects of reoperation on treatment outcome. Methods Among adult patients operated on for acute SDH between 2013 and 2017, patients reoperated within 14 days after the primary surgery were identified. In all patients, parameters were identified that related to the patient (age, anticoagulation, antiplatelet, and antiepileptic treatment, and alcohol intoxication), trauma (Glasgow Coma Score, SDH thickness, midline shift, midline shift /hematoma thickness rate, other surgical lesion, primary surgery-trephination, craniotomy, or decompressive craniotomy), and Glasgow Outcome Score (GOS). The reasons for reoperation and intervals between primary surgery and reoperation were studied. Results Of 86 investigated patients, 24 patients were reoperated (27.9%), with a median interval of 2 days between primary surgery and reoperation. No significant differences in patients and injury-related factors were found between reoperated and non-reoperated patients. The rate of primary craniectomies was higher in non-reoperated patients (P = 0.066). The main indications for reoperation were recurrent /significant residual SDH (10 patients), contralateral SDH (5 patients), and expansive intracerebral hematoma or contusion (5 patients). The final median GOS was 3 in non-reoperated and 1.5 in reoperated patients, with good outcomes in 41.2% of non-reoperated and 16.7% of reoperated patients. Conclusions Reoperation after acute SDH surgery is associated with a significantly worse prognosis. Recurrent /significant residual SDH and contralateral SDH are the most frequently found reasons for reoperation. None of the analyzed parameters were significant reoperation predictors.