Chronic Subdural Hematoma in Elderly Taiwan Patients: A Retrospective Analysis of 342 Surgical Cases

Background: Chronic subdural hematoma (CSDH) is common clinical entities in neurosurgical practice. Although several studies have focused on reporting surgical treatment of CSDH in mixed patient populations, there are few data concerning the risk factors, complications, and recurrence in the elderly. This study intended to delineate the perioperative risks, surgical outcomes, and recurrence in elderly patients with CSDH. Methods: A retrospective review of 342 age >= 65 years patients with surgically treated CSDH at our institution from 2001 to 2011 was conducted. These patients were divided into three groups according to age (Group A: 65-74 years, Group B: 75-84 years, and Group C: 85-97 years). The demographics, perioperative risk, surgical results, complications, and recurrence were analyzed. The surgical procedure included burr-hole craniostomy with a subdural drainage in each patient. The outcomes were evaluated with initial Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) at discharge. Results: The mean age was 77.2 +/- 11.4 years, (M:F ratio = 2.2:1). The postoperative neurological status was improved in all subgroups. The overall outcome was favorable in 83.3%, with median GCS was 15, and GOS, 1-2 at discharge recovery. The patients with lower initial GCS and higher GOS at discharge had a higher recurrence rate. The complication and mortality rates did not differ significantly within the age groups. Conclusion: An observed correlation is apparent between preoperative status and outcome. Burr-hole craniostomy should be the method of choice for surgical treatment of CSDH. Copyright (C) 2014, Taiwan Society of Geriatric Emergency 82 Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.