Evidence map›Paper›PMID 33796888›Full record

ArticleActa neurochirurgica2021

Risk factors for need of reoperation in bilateral chronic subdural haematomas.

Shaian Zolfaghari, Jiri Bartek, Felix Djärf, San-San Wong, Isabelle Strom, Nils Ståhl, Asgeir S Jakola, Henrietta Nittby Redebrandt

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

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 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 13% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Risk Factors of Chronic Subdural Hematoma Recurrence: A Systematic Review.Medical journal of the Islamic Republic of Iran · 2025
    Review
  4. Article
  5. Article
  6. Article
  7. Surgical Treatment of Bilateral Chronic Subdural Hematoma.Computational intelligence and neuroscience · 2022
    Article
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

8 authors at 3 institutions in 3 countries.

Shaian ZolfaghariDepartment of Neurosurgery, Institution of Clinical Sciences, Lund University, Lund, Sweden. Shaian.zolfaghari@med.lu.se.ORCID 0000-0002-4904-7665
Jiri BartekDepartment of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Felix DjärfDepartment of Neurosurgery, Institution of Clinical Sciences, Lund University, Lund, Sweden.
San-San WongDepartment of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Isabelle StromDepartment of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Nils StåhlDepartment of Neurosurgery, Institution of Clinical Sciences, Lund University, Lund, Sweden.
Asgeir S JakolaDepartment of Neurosurgery, St. Olavs Hospital, Trondheim, Norway.
Henrietta Nittby RedebrandtDepartment of Neurosurgery, Institution of Clinical Sciences, Lund University, Lund, Sweden.
Lund University · SEKarolinska University Hospital · SESahlgrenska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic subdural haematoma (CSDH) is one of the most common neurosurgical diseases. A subtype of CSDH is bilateral chronic subdural haematoma (bCSDH) which represents 20-25% of patients with CSDH and has a higher recurrence rate. There is no clear consensus on how bCSDH should be treated regarding upfront unilateral- or bilateral evacuation of both haematomas. The purpose of this study was to identify risk factors associated with reoperation of bCSDH.

methodsA total of 326 patients with radiological evidence of bCSDH were included in this retrospective cohort study where 133 (40.8%) patients underwent primary bilateral evacuation and 193 (59.2%) primary unilateral evacuation. The two centres operated using different surgical approaches. Analyses were performed to identify risk factors associated with reoperation of bCSDH. Reoperation rate was defined as reoperation of CSDH on either side of the hemisphere within 3 months after primary evacuation.

resultsThe cohort had a total reoperation rate of 26.4%. Patients which underwent unilateral evacuation had a reoperation rate of 32.1%, and the bilateral group had a reoperation rate of 18.0% (p=0.005). Multivariable logistic regression identified unilateral evacuation (OR 1.91, p=0.022) and complications according to Ibanez (OR 2.20, p=0.032) to be associated with the need of reoperation of bCSDH. One-burr hole craniostomy with active subgaleal drain was primarily performed in bilateral approach (69.4%) whereas patients operated with minicraniotomy with passive subdural drain were primarily operated by unilateral evacuation of the larger symptomatic side (92.8%).

conclusionsUnilateral evacuation of bCSDH was associated with a higher risk for reoperation than upfront bilateral evacuations in this study. There is a need to further discuss the criteria for uni- or bilateral evacuation since patients are treated differently at different centres.

Indexed as

Hematoma, Subdural, ChronicAgedAged, 80 and overFemaleHumansMaleMiddle AgedReoperationRetrospective StudiesRisk FactorsTrephiningBilateralChronic subdural haematomaOutcomeRecurrence

Identifiers

PMID33796888
PMCPMC8195919
OpenAlexW3142907586

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Registered trials

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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.