Does Drain Position and Duration Influence Outcomes in Patients Undergoing Burr-Hole Evacuation of Chronic Subdural Hematoma? Lessons from a UK Multicenter Prospective Cohort Study

Neurosurgery
Laurence Johann GlanczBritish Neurosurgical Trainee Research Collaborative (BNTRC)

Abstract

Drain insertion following chronic subdural hematoma (CSDH) evacuation improves patient outcomes. To examine whether this is influenced by variation in drain location, positioning or duration of placement. We performed a subgroup analysis of a previously reported multicenter, prospective cohort study of CSDH patients performed between May 2013 and January 2014. Data were analyzed relating drain location (subdural or subgaleal), position (through a frontal or parietal burr hole), and duration of insertion, to outcomes in patients aged >16 yr undergoing burr-hole drainage of primary CSDH. Primary outcomes comprised modified Rankin scale (mRS) at discharge and symptomatic recurrence requiring redrainage within 60 d. A total of 577 patients were analyzed. The recurrence rate of 6.7% (12/160) in the frontal subdural drain group was comparable to 8.8% (30/343) in the parietal subdural drain group. Only 44/577 (7.6%) patients underwent subgaleal drain insertion. Recurrence rates were comparable between subdural (7.7%; 41/533) and subgaleal (9.1%; 4/44) groups (P = .95). We found no significant differences in discharge mRS between these groups. Recurrence rates were comparable between patients with postoperative drainage for 1 or 2 d, 6...Continue Reading

References

Nov 20, 2009·British Journal of Neurosurgery·Guang Jie YuYong Gang Jiang
Jan 5, 2011·Acta neurochirurgica·Marcos Escosa BaéPedro de Las Heras Echeverría
Jun 15, 2012·Neurosurgical Review·Shigeo OhbaHideki Murakami
Sep 24, 2013·British Journal of Neurosurgery·Ian C CoulterUNKNOWN UK Neurosurgical Research Network, British Neurosurgical Trainee Research Collaborative
Jul 6, 2014·Journal of Neurosurgery·Weiming LiuRob J M Groen
Nov 12, 2016·Journal of Neurosurgery·Paul M BrennanUNKNOWN British Neurosurgical Trainee Research Collaborative
Feb 23, 2017·Neurological Research·Aydemir KaleŞanser Gül
Mar 30, 2017·Acta neurochirurgica·Mathew R GuilfoyleThomas Santarius

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Citations

May 19, 2019·Acta Neurologica Scandinavica·Sae-Yeon WonJuergen Konczalla
Apr 28, 2020·Acta neurochirurgica·Laurence Johann GlanczUNKNOWN British Neurosurgical Trainee Research Collaborative (BNTRC)
Nov 11, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Opšenák RenéKolarovszki Branislav
May 12, 2020·Frontiers in Neurology·Ladina GreuterJehuda Soleman
Mar 18, 2021·Techniques in Coloproctology·M KumarD Hind
Jul 31, 2021·Acta neurochirurgica·Shaian ZolfaghariHenrietta Nittby Redebrandt

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