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.

Basic information

Original name

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

Authors

CHRASTINA, Jan (203 Czech Republic, guarantor, belonging to the institution), Čeněk ŠILAR (203 Czech Republic, belonging to the institution), Tomáš ZEMAN (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Jan KRAJSA (203 Czech Republic, belonging to the institution), Barbora MUSILOVÁ (203 Czech Republic, belonging to the institution) and Zdeněk NOVÁK (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.693

RIV identification code

RIV/00216224:14110/20:00115103

Organization unit

Faculty of Medicine

DOI

UT WoS

000522839100012

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 17/7/2020 07:14, Mgr. Tereza Miškechová

Abstract

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.