TY  - JOUR
PY  - 2019//
TI  - Risk factors for recurrent hematomas after surgery for acute traumatic subdural hematoma
JO  - World neurosurgery
A1  - Heino, Iiro
A1  - Frantzén, Janek
A1  - Rinne, Jaakko
A1  - Girard, Romuald
A1  - Cao, Ying
A1  - Sajanti, Antti
A1  - Katila, Ari J.
A1  - Posti, Jussi P.
A1  - Takala, Riikka S. K.
A1  - Tenovuo, Olli
A1  - Koskimäki, Janne
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: The development of postcraniotomy hematoma (PCH) after surgery for acute traumatic subdural hematoma (aSDH) has been associated with increased risk for poor outcome. The risk factors contributing to PCH remain poorly understood. Our aim was to study potential risk factors for PCH in a consecutive series of surgically evacuated patients with aSDH. <br><br>METHODS: 132 patients with aSDH operated at Turku University Hospital, Turku, Finland, between 2008-2012 were enrolled in this retrospective cohort study. The demographic, clinical, laboratory and imaging data were collected from the medical records. A comprehensive analysis of the data using six different univariate methods including machine learning and multivariate analyses was conducted to identify factors related to PCH. <br><br>RESULTS: The incidence of PCH after a primary surgery for traumatic aSDH was 10.6%. Patients suffering from PCH were younger (p = 0.04). There was no difference in the use of anticoagulant or antiplatelet medication between patients with and without PCH. Multivariate analyses identified alcohol inebriation at the time of injury (OR 12.67, p = 0.041) and hypocapnia (OR 26.09, p = 0.003) as independent risk factors for PCH. The patients with PCH had less often hyponatremia (OR 0.08, p = 0.018) and their maximal systolic blood pressures were lower (OR 0.94, p = 0.009). The AUC for the multivariate model was 0.96 (p = 0.049) with a Youden index of J = 0.88. <br><br>CONCLUSIONS: The results suggest that alcohol inebriation at the time of injury and hypocapnia during hospitalization are risk factors for the development of PCH.<br><br>Copyright © 2019 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-8750
UR  - http://dx.doi.org/10.1016/j.wneu.2018.12.155
ID  - ref1
ER  -