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.