Authors: Valeri Borger Hartmut Vatter Ági Oszvald Gerhard Marquardt Volker Seifert Erdem Güresir
Publish Date: 2012/07/08
Volume: 154, Issue: 9, Pages: 1549-1554
Abstract
Chronic subdural haematoma cSDH is a common disease in neurosurgical practise especially in elderly patients This is of growing importance as the number of elderly people in the population is increasing steadily There are scarce data focussing especially on elderly patients with cSDH This study intended to evaluate the outcome and perioperative risks in elderly patients with cSDHWe retrospectively reviewed medical records of 322 consecutive patients aged ≥65 years treated at our department between 2002 and 2009 focussing on outcome aetiology perioperative risks recurrence rate and cofactors such as concomitant diseases and therapy with anticoagulants The surgical procedure included burrhole craniostomy followed by insertion of a subdural drain in each case The outcome was classified according to the Karnofsky performance status KPS and modified Rankin Scale mRS score Patients were divided into three groups according to age group I age 65–74 years group II 75–84 years group III 85–94 yearsThree hundred twentytwo patients underwent burrhole craniostomy for cSDH in 399 surgical procedures The mean age was 76 ± 79 years After surgery the mean neurological status improved in all three groups Overall favourable outcome mRS 0–2 was achieved in 83 in group I 68 in group II and 51 in group III respectively The rate of recurrence was lower in group III 75 compared to groups I 215 and II 2737 p = 0004 Overall complication rates and perioperative mortality 275 did not differ significantly between the age groupsThe data of the current study suggest that treatment of cSDH is safe in elderly patients Patients aged above 85 years carry a greater risk for perioperative complications ie aSDH and therefore have to be examined and monitored meticulously in order to prevent complicationsPortions of this work were presented as a oral presentation at the 61st Annual Meeting of German Society of Neurosurgery DGNC Mannheim Germany 21–25 September 2010 and at the 128th Meeting of the German Society of Surgery DGCH Munich Germany 3–6 May 2011
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