Efficacy and safety of postoperative early mobilization for chronic subdural hematoma in elderly patients

Kurabe, Satoshi; Ozawa, Tsunenori; Watanabe, Tôru; Aiba, Tsuneo

doi:10.1007/s00701-010-0627-4

Cited by 66 publications

(42 citation statements)

References 10 publications

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“…Despite these concerns, the frequency of a trauma history (head injury or fall, M:F 50% vs. 57% -the second largest risk factor) compared favourably with 56% reported by Ramachandran et al [18] in a much larger series of 647 CSDH cases. Furthermore, a history of alcohol abuse/dependence (M:F 17% vs. 16%) was also of a similar order to that reported in other studies (11-24%) [19][20][21].…”

Section: Discussionsupporting

confidence: 78%

“…In particular, there was no significant gender difference in either a history of trauma (head injury or fall) (P = 0.37) or alcohol abuse/dependence/intoxication (P = 0.89). Indeed, frequencies for alcohol abuse/dependence of 11-24% [19][20][21] render it improbable that this risk factor alone could ever explain a 2:1 male bias. Traditional assumptions therefore appear unsound.…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Risk factors for chronic subdural haematoma formation do not account for the established male bias

Marshman

Manickam

Carter

2015

Clinical Neurology and Neurosurgery

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 95%

Risk factors for chronic subdural haematoma formation do not account for the established male bias

Marshman

Manickam

Carter

2015

Clinical Neurology and Neurosurgery

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“…For instance, the study by Nakajima et al differs fundamentally from the others in the lack of closed system drainage. Although the studies by Abouzari et al and Kurabe et al [1,45] employed similar surgical paradigms, they differ significantly in the age of the patients they examine. The mean age of patients examined by Kurabe et al [45] was 77.3 years, whereas the median age in the study by Abouzari et al [1] was 56.5 years.…”

Section: Mobilization Of Patients Following Csdh Drainagementioning

confidence: 96%

“…They found no significant differences in rates of recurrence between patients who remained recumbent for 3 days postoperatively relative to those who assumed a sitting position on the day following the operation. In the second study, Kurabe et al [45] undertook a prospective study of 182 patients aged 65 years and greater who underwent single burr-hole drainage. The incidences of complications and recurrences were compared between 91 patients who were maintained in a supine position with continuous drainage and 91 patients who were mobilized (sitting or walking) on the day of surgery, and whose drains were discontinued on the day after surgery.…”

Section: Mobilization Of Patients Following Csdh Drainagementioning

confidence: 99%

The surgical management of chronic subdural hematoma

et al. 2011

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Chronic subdural hematoma (cSDH) is an increasingly common neurological disease process. Despite the wide prevalence of cSDH, there remains a lack of consensus regarding numerous aspects of its clinical management. We provide an overview of the epidemiology and pathophysiology of cSDH and discuss several controversial management issues, including the timing of post-operative resumption of anticoagulant medications, the effectiveness of anti-epileptic prophylaxis, protocols for mobilization following evacuation of cSDH, as well as the comparative effectiveness of the various techniques of surgical evacuation. A PubMed search was carried out through October 19, 2010 using the following keywords: "subdural hematoma", "craniotomy", "burr-hole", "management", "anticoagulation", "seizure prophylaxis", "antiplatelet", "mobilization", and "surgical evacuation", alone and in combination. Relevant articles were identified and back-referenced to yield additional papers. A meta-analysis was then performed comparing the efficacy and complications associated with the various methods of cSDH evacuation. There is general agreement that significant coagulopathy should be reversed expeditiously in patients presenting with cSDH. Although protocols for gradual resumption of anti-coagulation for prophylaxis of venous thrombosis may be derived from guidelines for other neurosurgical procedures, further prospective study is necessary to determine the optimal time to restart full-dose anti-coagulation in the setting of recently drained cSDH. There is also conflicting evidence to support seizure prophylaxis in patients with cSDH, although the existing literature supports prophylaxis in patients who are at a higher risk for seizures. The published data regarding surgical technique for cSDH supports primary twist drill craniostomy (TDC) drainage at the bedside for patients who are high-risk surgical candidates with non-septated cSDH and craniotomy as a first-line evacuation technique for cSDH with significant membranes. Larger prospective studies addressing these aspects of cSDH management are necessary to establish definitive recommendations.

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“…In a recent review article it was concluded that there were significant physical benefits associated with inpatient mobilization and no evidence for associated risk of adverse events (Kalish, Lee, & Dabney, 2013). Benefits included less pain (Augustin, de Quadros, & Sarmento-Leite, 2010), less risk of delirium (Schweickert et al, 2009) or adverse events such as deep vein thrombosis (Chandrasekaran, Ariaretnam, Tsung, & Dickison, 2009; Nakao et al, 2010), urinary tract infections (Kurabe, Ozawa, Watanabe, & Aiba, 2010; Langhorne et al, 2010) or pneumonia (Clark, Lowman, Griffin, Matthews, & Reiff, 2013; Kurabe et al, 2010), and no increase in falls (Clark et al, 2013; Fisher, Galloway, et al, 2011). Moreover, ambulation and other types of physical activity helped to prevent the all too common functional decline noted in older hospitalized patients (Cumming et al, 2011; Langhorne et al, 2010).…”

mentioning

confidence: 99%

Feasibility and Efficacy of Function-Focused Care for Orthopedic Trauma Patients

Wells

Galik

Holtzman

et al. 2016

Journal of Trauma Nursing

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To overcome challenges associated with optimizing function and physical activity among hospitalized older adults we developed Function Focused Care for Acute Care (FFC-AC). The purpose of this study was to test the feasibility and preliminary effectiveness of this intervention. We hypothesized that hospitalized trauma patients exposed to FFC-AC would: (1) maintain or improve function, spend more time in physical activity and have fewer adverse events between admission and discharge; and (2) maintain or improve function, have less fear of falling, fewer depressive symptoms, less pain, be more physically resilient and be less likely to experience adverse events at one month post discharge compared to those exposed to FFC-Education Only (EO). FFC-AC was implemented by a Research Function Focused Care Nurse who worked on the participating units for 20 hours a week for 16 months to implement the three components of FFC-AC. The sample included 89 older orthopedic trauma patients the majority of whom were female (N=59, 66%), white (N= 82, 92%) and not married (N=53, 59%). At discharge and/or 30 days post discharge participants in the treatment site showed greater improvement in function, less fear of falling and better physical resilience when compared to those in the FFC-EO site. Future research is needed to continue to work on engaging staff in function focused care approaches and optimizing the hospital environment and policies to support nurses in this type of care approach.

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Efficacy and safety of postoperative early mobilization for chronic subdural hematoma in elderly patients

Abstract: The results suggest that EM after one burr-hole surgery prevents postoperative complications without increasing the risk of recurrence in CSDH patients > or =65 years of age.

Cited by 66 publications

References 10 publications

Risk factors for chronic subdural haematoma formation do not account for the established male bias

Risk factors for chronic subdural haematoma formation do not account for the established male bias

The surgical management of chronic subdural hematoma

Feasibility and Efficacy of Function-Focused Care for Orthopedic Trauma Patients

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