Functional outcomes of surgically treated chronic subdural hematoma and the factors associated with outcomes: a retrospective study

Abstract

Objective The incidence of chronic subdural hematoma (CSDH) and its peak age of occurrence are increasing with the rapid progression of population aging. Surgical treatment for symptomatic CSDH has shown favorable clinical outcomes (>80%). Since some recent reports have described unfavorable outcomes of surgical treatment of CSDH in older patients, we evaluated the functional outcomes of CSDH in older patients. Methods We retrospectively analyzed the functional outcomes of CSDH patients aged >60 years who underwent burr-hole surgery between January 2017 and December 2021. Using the modified Rankin scale (mRS), we analyzed the functional outcomes of burr surgery and investigated the factors affecting the surgical outcomes. Results In total, 172 patients (115 men and 57 women) were analyzed for the functional outcomes of surgery. Functional outcomes improved in 120 patients (69.8%) and worsened in 52 patients (30.2%). Age (P=0.046), preoperative mRS (P=0.002), and the presence of underlying disease (P=0.025) were factors affecting the postoperative functional status. Conclusion The decision regarding surgical treatment of CSDH in older patients should be made carefully, considering their preoperative functional status and underlying disease. Keywords: Treatment outcome; Trephining; Aged; Chronic subdural hematoma