The Value of Suction Drainage for a Chronic Subdural Hematoma in Elderly Patients: A Retrospective Cohort study

Background: The use of suction in the subgaleal drainage system after the burr-hole evacuation of chronic subdural hematoma (CSDH) is still debatable. This study aimed to investigate the value of adding suction to the drainage system of CSDH in elderly patients. Methods: This cohort study retrospectively reviewed the data of the CSDH patients operated on at our university hospital in the last eight years. The inclusion criteria were elderly patients who underwent evacuation of a unilateral CSDH through two burr holes followed by placing a subgaleal drainage tube. Two hundred seventy-three consecutive patients met the inclusion criteria. Seventy-six patients (27.8%) received suction drainage. The comparison between groups with qualitative data was done using the chi-square test. The comparison between groups with quantitative data was done using the t-test. The statistical analyses were conducted using SPSS software version 21 (IBM Corp., Armonk, New York, USA). Results: There were no statistically significant differences between the suction and the nonsuction drainage groups regarding the hospitalization period, the postoperative seizures, or the recurrence rate. However, the postoperative pneumocephalus volume in the suction drainage group was significantly lower than in the non-suction drainage group. None of the patients developed acute subdural or intracerebral hemorrhage. Conclusions: Suction drainage did not add statistically significant value to the closed drainage system regarding the hospitalization period, postoperative seizures, or recurrence rate of the CSDH. A prospective controlled study is needed to increase the evidence for this finding.