Evidence map›Paper›PMID 33464424›Full record

ArticleActa neurochirurgica2021

Awake surgery in sitting position for chronic subdural hematoma.

Milan Lepić, Stefan Mandić-Rajčević, Goran Pavlićević, Nenad Novaković, Lukas Rasulić

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Article in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Milan LepićMedical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia.
Stefan Mandić-RajčevićSchool of Public Health and Health Management and Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Goran PavlićevićMedical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia.
Nenad NovakovićMedical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia.
Lukas RasulićFaculty of Medicine, University of Belgrade, Belgrade, Serbia. lukas.rasulic@gmail.com.
Military Medical Academy · RSInstitute of Public Health of Serbia · RSUniversity of Belgrade · RSUniversity of Defence · RS

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic subdural hematoma (CSDH) is a common pathology in neurosurgery, especially in the elderly patients, and its incidence is likely to double in the next decade. Considering various features of CSDH and the procedure itself, a sitting position may retain the best characteristics of classic positioning, while offering additional comfort for both the patient and the surgeon. The aim of this study was to describe the technical aspects of this procedure in the sitting position, to evaluate safety and discuss the benefits and shortcomings of this modification.

methodThis study included a series of 55 patients surgically treated for CSDH in a sitting position at our department between December 2017 and September 2019, representing all the patients operated on during the study period by a single surgeon. Bilateral hematomas were present in 19 patients. Outcomes, during the 6-month follow-up period, were defined as good (CSDH and symptoms resolved) or poor (lethal outcome or reoccurrence). All complications were noted, with emphasis on pneumocephalus, and complications related to the sitting position: tension pneumocephalus, venous air embolism, and compression nerve injury.

resultsComplications previously associated with the sitting position were not noted. The Glasgow Coma Scale and Markwalder Grading Scale scores improved significantly after the surgery (p < 0.001 and p = 0.018). Complications were noted in 17 patients (30.9%), and included 5 cerebrospinal fluid drainages, 3 hematoma reoccurrences, 2 wound infections, and 9 more single-occurring complications. The in-hospital mortality was 5.4% (3 out of 55 patients), while the overall mortality was 16.4% within the 6-month follow-up period.

conclusionsIn our series, even the severely ill patients tolerated the position well. No complications associated with the sitting position were noted. Future studies should confirm the safety of this position and evaluate the potential advantages for both the patient and the surgeon.

Indexed as

Hematoma, Subdural, ChronicBrain NeoplasmsHumansRetrospective StudiesSitting PositionWakefulnessChronic subdural hematomaCraniostomyOutcomeReoccurrenceSitting position

Identifiers

PMID33464424
OpenAlexW3124053199

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.