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@article{1554136,
author = {Chrastina, Jan and Šilar, Čeněk and Zeman, Tomáš and Svoboda, Michal and Krajsa, Jan and Musilová, Barbora and Novák, Zdeněk},
article_location = {HEIDELBERG},
article_number = {2},
doi = {http://dx.doi.org/10.1007/s00068-019-01077-6},
keywords = {Brain injury; Acute subdural hematoma; Reoperation; Contralateral subdural hematoma; Decompressive craniectomy},
language = {eng},
issn = {1863-9933},
journal = {European Journal of Trauma and Emergency Surgery},
title = {Reoperations after surgery for acute subdural hematoma: reasons, risk factors, and effects},
url = {https://link.springer.com/article/10.1007/s00068-019-01077-6},
volume = {46},
year = {2020}
}
TY - JOUR
ID - 1554136
AU - Chrastina, Jan - Šilar, Čeněk - Zeman, Tomáš - Svoboda, Michal - Krajsa, Jan - Musilová, Barbora - Novák, Zdeněk
PY - 2020
TI - Reoperations after surgery for acute subdural hematoma: reasons, risk factors, and effects
JF - European Journal of Trauma and Emergency Surgery
VL - 46
IS - 2
SP - 347-355
EP - 347-355
PB - SPRINGER HEIDELBERG
SN - 18639933
KW - Brain injury
KW - Acute subdural hematoma
KW - Reoperation
KW - Contralateral subdural hematoma
KW - Decompressive craniectomy
UR - https://link.springer.com/article/10.1007/s00068-019-01077-6
L2 - https://link.springer.com/article/10.1007/s00068-019-01077-6
N2 - 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.
ER -
CHRASTINA, Jan, Čeněk ŠILAR, Tomáš ZEMAN, Michal SVOBODA, Jan KRAJSA, Barbora MUSILOVÁ and Zdeněk NOVÁK. Reoperations after surgery for acute subdural hematoma: reasons, risk factors, and effects. \textit{European Journal of Trauma and Emergency Surgery}. HEIDELBERG: SPRINGER HEIDELBERG, 2020, vol.~46, No~2, p.~347-355. ISSN~1863-9933. Available from: https://dx.doi.org/10.1007/s00068-019-01077-6.
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