Chronic subdural hematoma in patients aged 80 years and older: A two-centre study
•Patients over 80 with chronic subdural hematoma are more and more very frequent in daily practice.•Risk factors influencing outcome of surgery have been analysed in 151 surgically treated patients.•Higher CCI correlated with complications (OR = 3,18) and 6-month mortality (OR = 11,71).•Patients und...
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| Veröffentlicht in: | Clinical neurology and neurosurgery 2018-07, Vol.170, p.88-92 |
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| container_title | Clinical neurology and neurosurgery |
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| creator | De Bonis, Pasquale Olei, Simone Mongardi, Lorenzo Cavallo, Michele Alessandro Santantonio, Mariaconsiglia Trevisi, Gianluca Anile, Carmelo Mangiola, Annunziato |
| description | •Patients over 80 with chronic subdural hematoma are more and more very frequent in daily practice.•Risk factors influencing outcome of surgery have been analysed in 151 surgically treated patients.•Higher CCI correlated with complications (OR = 3,18) and 6-month mortality (OR = 11,71).•Patients under antithrombotic drugs had a longer hospital stay (OR = 3,07).•CCI can represent a useful tool to predict outcome after surgery for CSDH in very elderly patients.
Chronic subdural hematoma (CSDH) is a common condition in the elderly, and the ageing of population will increase the number of “superaged” patients presenting this pathology for the years to come. Few studies investigating the outcome of superaged patients surgically treated for CSDH are available, and study populations are generally small. The outcome of surgically treated patients and risk factors are not completely clear.
Aim of the work is to identify the risk factors which may influence the outcome of patients aged 80 years and older surgically treated for CSDH.
This is a retrospective two-centre study including 151 surgically treated patients. A univariate (Fisher exact test) and multivariate (logistic regression) analysis of possible risk factors influencing outcome was performed. Outcome was expressed as: 6-month clinical outcome, 6-month mortality, complications and length of hospital stay.
Univariate analysis showed an association between Charlson Comorbidity Index (CCI) and 6-month clinical outcome (p = 0,048), complications (p = 0,034) and 6-month mortality (p = 0,007). Antithrombotic drugs were associated with longer hospital stay (p |
| doi_str_mv | 10.1016/j.clineuro.2018.05.002 |
| format | Article |
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Chronic subdural hematoma (CSDH) is a common condition in the elderly, and the ageing of population will increase the number of “superaged” patients presenting this pathology for the years to come. Few studies investigating the outcome of superaged patients surgically treated for CSDH are available, and study populations are generally small. The outcome of surgically treated patients and risk factors are not completely clear.
Aim of the work is to identify the risk factors which may influence the outcome of patients aged 80 years and older surgically treated for CSDH.
This is a retrospective two-centre study including 151 surgically treated patients. A univariate (Fisher exact test) and multivariate (logistic regression) analysis of possible risk factors influencing outcome was performed. Outcome was expressed as: 6-month clinical outcome, 6-month mortality, complications and length of hospital stay.
Univariate analysis showed an association between Charlson Comorbidity Index (CCI) and 6-month clinical outcome (p = 0,048), complications (p = 0,034) and 6-month mortality (p = 0,007). Antithrombotic drugs were associated with longer hospital stay (p < 0,001). Logistic regression analysis showed an association between CCI and complications (p = 0,016, HR = 3,18) and 6-month mortality (p = 0,034, HR = 11,71), and between antithrombotic drugs and longer hospital stay (p = 0,002, HR = 3,07).
Age alone is not a predictor of bad outcome for patients aged 80 years and older surgically treated for CSDH. Charlson Comorbidity Index (CCI) may prove a valuable outcome predicting tool in these patients, and a longer hospital stay may be anticipated for patients under antithrombotic agents.</description><identifier>ISSN: 0303-8467</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2018.05.002</identifier><identifier>PMID: 29753169</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Age ; Anticoagulant therapy ; Anticoagulants ; Antiplatelet therapy ; Blood ; Brain ; Charlson comorbidity index ; Chronic subdural hematoma ; Clinical outcomes ; Comorbidity ; Complications ; Drugs ; Dura mater ; Elderly patients ; Geriatrics ; Hematoma ; Hospitals ; Medical imaging ; Meninges ; Mortality ; Neurology ; Older people ; Oldest old people ; Population studies ; Regression analysis ; Risk factors ; Surgery ; Trauma</subject><ispartof>Clinical neurology and neurosurgery, 2018-07, Vol.170, p.88-92</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier B.V.</rights><rights>Copyright Elsevier Limited Jul 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-8e02d1eb284a463599e4e8db214b48844e0db803b67250af75a0ec89c7e651133</citedby><cites>FETCH-LOGICAL-c396t-8e02d1eb284a463599e4e8db214b48844e0db803b67250af75a0ec89c7e651133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0303846718301847$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29753169$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Bonis, Pasquale</creatorcontrib><creatorcontrib>Olei, Simone</creatorcontrib><creatorcontrib>Mongardi, Lorenzo</creatorcontrib><creatorcontrib>Cavallo, Michele Alessandro</creatorcontrib><creatorcontrib>Santantonio, Mariaconsiglia</creatorcontrib><creatorcontrib>Trevisi, Gianluca</creatorcontrib><creatorcontrib>Anile, Carmelo</creatorcontrib><creatorcontrib>Mangiola, Annunziato</creatorcontrib><title>Chronic subdural hematoma in patients aged 80 years and older: A two-centre study</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>•Patients over 80 with chronic subdural hematoma are more and more very frequent in daily practice.•Risk factors influencing outcome of surgery have been analysed in 151 surgically treated patients.•Higher CCI correlated with complications (OR = 3,18) and 6-month mortality (OR = 11,71).•Patients under antithrombotic drugs had a longer hospital stay (OR = 3,07).•CCI can represent a useful tool to predict outcome after surgery for CSDH in very elderly patients.
Chronic subdural hematoma (CSDH) is a common condition in the elderly, and the ageing of population will increase the number of “superaged” patients presenting this pathology for the years to come. Few studies investigating the outcome of superaged patients surgically treated for CSDH are available, and study populations are generally small. The outcome of surgically treated patients and risk factors are not completely clear.
Aim of the work is to identify the risk factors which may influence the outcome of patients aged 80 years and older surgically treated for CSDH.
This is a retrospective two-centre study including 151 surgically treated patients. A univariate (Fisher exact test) and multivariate (logistic regression) analysis of possible risk factors influencing outcome was performed. Outcome was expressed as: 6-month clinical outcome, 6-month mortality, complications and length of hospital stay.
Univariate analysis showed an association between Charlson Comorbidity Index (CCI) and 6-month clinical outcome (p = 0,048), complications (p = 0,034) and 6-month mortality (p = 0,007). Antithrombotic drugs were associated with longer hospital stay (p < 0,001). Logistic regression analysis showed an association between CCI and complications (p = 0,016, HR = 3,18) and 6-month mortality (p = 0,034, HR = 11,71), and between antithrombotic drugs and longer hospital stay (p = 0,002, HR = 3,07).
Age alone is not a predictor of bad outcome for patients aged 80 years and older surgically treated for CSDH. Charlson Comorbidity Index (CCI) may prove a valuable outcome predicting tool in these patients, and a longer hospital stay may be anticipated for patients under antithrombotic agents.</description><subject>Age</subject><subject>Anticoagulant therapy</subject><subject>Anticoagulants</subject><subject>Antiplatelet therapy</subject><subject>Blood</subject><subject>Brain</subject><subject>Charlson comorbidity index</subject><subject>Chronic subdural hematoma</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Drugs</subject><subject>Dura mater</subject><subject>Elderly patients</subject><subject>Geriatrics</subject><subject>Hematoma</subject><subject>Hospitals</subject><subject>Medical imaging</subject><subject>Meninges</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Older people</subject><subject>Oldest old people</subject><subject>Population studies</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Trauma</subject><issn>0303-8467</issn><issn>1872-6968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1r3DAQhkVJaTbb_oUg6CUXO6MPy3JPDUvbBAKh0J6FLM02WmxrK9kJ---rsEkPueQ0DDzvO8NDyDmDmgFTl7vaDWHCJcWaA9M1NDUAf0dWTLe8Up3SJ2QFAkSlpWpPyVnOOwAQQukP5JR3bSOY6lbk5-Y-xSk4mpfeL8kO9B5HO8fR0jDRvZ0DTnOm9g96qoEe0KayTZ7GwWP6Qq_o_BgrV6CENM-LP3wk77d2yPjpea7J7-_ffm2uq9u7Hzebq9vKiU7NlUbgnmHPtbRSiabrUKL2PWeyl1pLieB7DaJXLW_AbtvGAjrduRZVw5gQa3Jx7N2n-HfBPJsxZIfDYCeMSzYchOatFJwX9PMrdBeXNJXvCiUlL2BRsybqSLkUc064NfsURpsOhoF5km525kW6eZJuoDFFegmeP9cv_Yj-f-zFcgG-HgEsPh4CJpNd8erQh4RuNj6Gt278A_czlGU</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>De Bonis, Pasquale</creator><creator>Olei, Simone</creator><creator>Mongardi, Lorenzo</creator><creator>Cavallo, Michele Alessandro</creator><creator>Santantonio, Mariaconsiglia</creator><creator>Trevisi, Gianluca</creator><creator>Anile, Carmelo</creator><creator>Mangiola, Annunziato</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201807</creationdate><title>Chronic subdural hematoma in patients aged 80 years and older: A two-centre study</title><author>De Bonis, Pasquale ; 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Chronic subdural hematoma (CSDH) is a common condition in the elderly, and the ageing of population will increase the number of “superaged” patients presenting this pathology for the years to come. Few studies investigating the outcome of superaged patients surgically treated for CSDH are available, and study populations are generally small. The outcome of surgically treated patients and risk factors are not completely clear.
Aim of the work is to identify the risk factors which may influence the outcome of patients aged 80 years and older surgically treated for CSDH.
This is a retrospective two-centre study including 151 surgically treated patients. A univariate (Fisher exact test) and multivariate (logistic regression) analysis of possible risk factors influencing outcome was performed. Outcome was expressed as: 6-month clinical outcome, 6-month mortality, complications and length of hospital stay.
Univariate analysis showed an association between Charlson Comorbidity Index (CCI) and 6-month clinical outcome (p = 0,048), complications (p = 0,034) and 6-month mortality (p = 0,007). Antithrombotic drugs were associated with longer hospital stay (p < 0,001). Logistic regression analysis showed an association between CCI and complications (p = 0,016, HR = 3,18) and 6-month mortality (p = 0,034, HR = 11,71), and between antithrombotic drugs and longer hospital stay (p = 0,002, HR = 3,07).
Age alone is not a predictor of bad outcome for patients aged 80 years and older surgically treated for CSDH. Charlson Comorbidity Index (CCI) may prove a valuable outcome predicting tool in these patients, and a longer hospital stay may be anticipated for patients under antithrombotic agents.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>29753169</pmid><doi>10.1016/j.clineuro.2018.05.002</doi><tpages>5</tpages></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete |
| subjects | Age Anticoagulant therapy Anticoagulants Antiplatelet therapy Blood Brain Charlson comorbidity index Chronic subdural hematoma Clinical outcomes Comorbidity Complications Drugs Dura mater Elderly patients Geriatrics Hematoma Hospitals Medical imaging Meninges Mortality Neurology Older people Oldest old people Population studies Regression analysis Risk factors Surgery Trauma |
| title | Chronic subdural hematoma in patients aged 80 years and older: A two-centre study |
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