Predicting Prognosis of Patients with Chronic Subdural Hematoma: A New Scoring System

Kwon, Churl‐Su; Al-Awar, Omar; Richards, Oliver C.; Izu, Alane; Lengvenis, Givi

doi:10.1016/j.wneu.2017.10.058

Cited by 36 publications

(23 citation statements)

References 20 publications

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“…[13][14][15] Previous studies have shown that age, presence of dementia and the severity of neurological symptoms on admission are correlated with the prognosis of CSDH patients. [1][2][3][4] The present study showed that frailty was associated with poor prognosis. Additionally, we investigated the contribution of frailty and correlated factors, including CCI and CONUT scores, to predict the prognosis for patients with CSDH.…”

Section: Discussionsupporting

confidence: 55%

“…Furthermore, most of the previous studies on CSDH focused on surgical method and recurrence reduction, and did not investigate the prognosis of CSDH . Previous studies have shown that age, presence of dementia and the severity of neurological symptoms on admission are correlated with the prognosis of CSDH patients . The present study showed that frailty was associated with poor prognosis.…”

Section: Discussionmentioning

confidence: 44%

“…Additionally, a multivariate analysis was carried out to evaluate the relationship between frailty and outcomes by adjusting for age; CFS, CCI, CONUT scores; and recurrence. Subsequently, we used the area under the receiver operating characteristic curve to compare the accuracy between the model with seven known clinical predictors (age, Glasgow Coma Scale, dementia, midline shift, hematoma thickness, and presence of motor deficit and disorientation on admission) and with six values examined in the present study (age, CFS, dementia, CCI score, CONUT score and recurrence). All statistical analyses were carried out with EZR (Saitama Medical Center, Jichi Medical University, Saitama, Japan), which is a graphical user interface for R (The R Foundation for Statistical Computing, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

“…Chronic subdural hematoma (CSDH) is one of the most common diseases encountered by healthcare professionals in the field of neurosurgery. In general, CSDH patients are considered to have a good prognosis; however, this presumption does not necessarily apply to all patients, especially among older individuals . Older people with CSDH are likely to have low functional status and poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…In general, CSDH patients are considered to have a good prognosis; however, this presumption does not necessarily apply to all patients, especially among older individuals. [1][2][3][4] Older people with CSDH are likely to have low functional status and poor prognosis. However, considering that older individuals with the same chronological age have considerably varied health and functional status, the prognosis of those with CSDH is not necessarily poor because of old age.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma

Shimizu

Sadatomo

Hara

et al. 2018

Geriatrics Gerontology Int

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Chronic subdural hematoma patients with frailty had a poorer prognosis than those without (median modified Rankin Scale: 4 and 2, P < 0.001; proportions of patients discharged to home: 35% and 91%, P < 0.001, respectively). After adjusting for patients' background, the patients' modified Rankin Scale scores at 3 months after surgery were found to be associated with age, controlling nutritional status score and recurrence, but not with frailty. However, receiver operating characteristic curves of the model with the Clinical Frailty Scale were more accurately correlated with prognosis than those of the model without this scale (area under the curve 0.98, 95% confidence interval 0.96-0.99; and 0.87, 95% confidence interval 0.82-0.91, respectively.) CONCLUSIONS: Chronic subdural hematoma patients with frailty had poorer prognosis than those without. The evaluation of the presence of frailty on admission can be an important factor in the prediction of the prognosis of chronic subdural hematoma patients. Geriatr Gerontol Int 2018; 18: 1173-1176.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 44%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma

Shimizu

Sadatomo

Hara

et al. 2018

Geriatrics Gerontology Int

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Rehabilitation for Chronic Subdural Hematoma in the Elderly

Tastaban

Turğut

2021

Subdural Hematoma

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External validation of prognostic models predicting outcome after chronic subdural hematoma

et al. 2022

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Background Several prognostic models for outcomes after chronic subdural hematoma (CSDH) treatment have been published in recent years. However, these models are not sufficiently validated for use in daily clinical practice. We aimed to assess the performance of existing prediction models for outcomes in patients diagnosed with CSDH. Methods We systematically searched relevant literature databases up to February 2021 to identify prognostic models for outcome prediction in patients diagnosed with CSDH. For the external validation of prognostic models, we used a retrospective database, containing data of 2384 patients from three Dutch regions. Prognostic models were included if they predicted either mortality, hematoma recurrence, functional outcome, or quality of life. Models were excluded when predictors were absent in our database or available for < 150 patients in our database. We assessed calibration, and discrimination (quantified by the concordance index C) of the included prognostic models in our retrospective database. Results We identified 1680 original publications of which 1656 were excluded based on title or abstract, mostly because they did not concern CSDH or did not define a prognostic model. Out of 18 identified models, three could be externally validated in our retrospective database: a model for 30-day mortality in 1656 patients, a model for 2 months, and another for 3-month hematoma recurrence both in 1733 patients. The models overestimated the proportion of patients with these outcomes by 11% (15% predicted vs. 4% observed), 1% (10% vs. 9%), and 2% (11% vs. 9%), respectively. Their discriminative ability was poor to modest (C of 0.70 [0.63–0.77]; 0.46 [0.35–0.56]; 0.59 [0.51–0.66], respectively). Conclusions None of the examined models showed good predictive performance for outcomes after CSDH treatment in our dataset. This study confirms the difficulty in predicting outcomes after CSDH and emphasizes the heterogeneity of CSDH patients. The importance of developing high-quality models by using unified predictors and relevant outcome measures and appropriate modeling strategies is warranted.

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Predicting Prognosis of Patients with Chronic Subdural Hematoma: A New Scoring System

Cited by 36 publications

References 20 publications

Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma

Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma

Rehabilitation for Chronic Subdural Hematoma in the Elderly

External validation of prognostic models predicting outcome after chronic subdural hematoma

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