ArticleNeurosurgical review2021
External validation and modification of the Oslo grading system for prediction of postoperative recurrence of chronic subdural hematoma.
Article in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Subgaleal/subperiosteal versus subdural drainage for chronic subdural hematoma: a systematic review and meta-analysis.Neurosurgical review · 2025Pooled it
- Radiological prognostic factors of chronic subdural hematoma recurrence: a systematic review and meta-analysis.Neuroradiology · 2021Pooled it
- Modified Puerto Rico Recurrence Scale for chronic subdural hematomas: augmenting the grading scale with postoperative pneumocephalus volume.Acta neurochirurgica · 2023Article
- Midline Shift in Chronic Subdural Hematoma : Interrater Reliability of Different Measuring Methods and Implications for Standardized Rating in Embolization Trials.Clinical neuroradiology · 2022Article
- Significance of Temporal Muscle Thickness in Chronic Subdural Hematoma.Journal of clinical medicine · 2022Article
- External validation of prognostic models predicting outcome after chronic subdural hematoma.Acta neurochirurgica · 2022Article
- A Validation Study for SHE Score for Acute Subdural Hematoma in the Elderly.Brain sciences · 2022Article
- Brain re-expansion predict the recurrence of unilateral CSDH: A clinical grading system.Frontiers in neurology · 2022Article
- Puerto Rico Recurrence Scale: Predicting chronic subdural hematoma recurrence risk after initial surgical drainage.Surgical neurology international · 2022Article
- Peripheral blood eosinophil and classification of residual hematoma help predict the recurrence of chronic subdural hematoma after initial surgery.Frontiers in surgery · 2022Article
- Modified Valsalva maneuver after burr-hole drainage of chronic subdural hematomas: A single-center cohort study.Frontiers in neurology · 2022Article
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9 authors at 1 institution in 1 country.
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Abstract
Recently, Oslo grading system (OGS) for prediction of recurrence in chronic subdural hematoma (cSDH) was introduced. The aim of the study was to validate and if applicable to modify the grading system. Data of all patients admitted to the Goethe University Hospital between 2016 and 2018 with chronic subdural hematoma were prospectively entered into a database. Dataset of patients with uni- (n = 272) and bilateral cSDH (n = 177) were used for the validation of OGS via logistic regression analysis. Additional predictors were identified and integrated to build a modified OGS (mOGS). Internal validation of the modified OGS was performed using same dataset of patients. The OGS showed a significant good predictive value with correlating increase of recurrence rate depending on the level of score in unilateral cSDH (p = 0.002). Regarding bilateral cSDH, there was no significant predictive value found (p = 0.921). By performing uni- and multivariate analysis, additional predictors for recurrence in uni- and bilateral cSDH were identified and integrated into the score system. Accordingly, the mOGS for unilateral cSDH inherited 4 components: previous OGS with 3 components (OR1.6) and seizure (OR2.5) (0 point, 0% recurrence rate; 1-2 points, 17.4%; 3-4 points, 30.6%; ≥ 5 points, 80%). Regarding bilateral cSDH, the mOGS consisted of 4 components as well: hypodense/gradation subtypes (OR3.3), postoperative unilateral volume > 80 mL (OR7.4), postoperative unilateral air trapping > 80 mL (OR15.3), and seizure (OR5.5) (0 point, 3.6% recurrence rate; 1 point, 30.6%; 2 points, 53.5%; 3 points, 58.3%; ≥ 4 points, 100%). Furthermore, the mOGS was internally verified showing high significant predictive power for recurrent hematoma in uni- (p = 0.004) and bilateral cSDH (p < 0.001). External validation of OGS showed accurate risk stratification of recurrence in unilateral cSDH; however, the validation failed for bilateral cSDH. Thus, mOGS was developed to strengthen its clinical utility and applicability.
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