ArticleJournal of Korean Neurosurgical Society2023
Balancing Bleeding Risk and Thromboembolic Complications in Elderly Chronic Subdural Hematoma Patients Undergoing Burr Hole Trephination : A Multicenter Retrospective Cohort Study and Literature Review.
Article in Journal of Korean Neurosurgical Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Anticoagulant and antiplatelet management in geriatric patients with chronic subdural hematoma: A systematic review.Neurosurgical review · 2026Pooled it
- Association between postoperative thromboembolic and hemorrhagic complications and clinical outcomes after surgery for chronic subdural hematoma in patients with anticoagulation therapy for atrial fibrillation.Acta neurochirurgica · 2025Trial
- Therapeutic efficacy of drilling drainage combined with intraoperative middle meningeal artery occlusion in the management of chronic subdural hematoma: a clinical study.Neurosurgical review · 2024Trial
- Risk prediction of traumatic and non-traumatic subdural hematoma after ischemic stroke: a nationwide competing-risk model with external validation.Neurosurgical review · 2026Article
- Clinical and Demographic Profile of Patients Undergoing Surgery for Chronic Subdural Hematoma at a Tertiary Care Hospital in Nepal: An Observational Study.JNMA; journal of the Nepal Medical Association · 2025Observational
- Evaluation of clinical outcome and predictive factors for thromboembolism or hemorrhagic complications in patients treated for chronic subdural hematoma. A prospective observational study.Neurosurgical review · 2025Observational
- Impact of preoperative antithrombotic discontinuation duration on clinical outcomes following hard channel surgery for chronic subdural hematoma.Frontiers in neurology · 2025Article
- Editors' Pick in November 2023.Journal of Korean Neurosurgical Society · 2023Article
- Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveChronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. The authors aimed to analyze the factors influencing outcome by targeting patients using AT and to establish a desirable treatment strategy.
methodsA retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. Outcomes included incidence of postoperative acute bleeding, recurrence rate, and morbidity or mortality rate. Patients were divided into the following four groups based on their history of AT use : no AT. Only antiplatelet agents (AP), only anticoagulants (AC), both of AP and AC. In addition, a concurrent literature review was conducted alongside our cohort study.
resultsOf 462 patients, 119 (119/462, 25.76%) were using AT. AP prescription did not significantly delay surgery (p=0.318), but AC prescription led to a significant increase in the time interval from admission to operation (p=0.048). After BHT, AP or AC intake significantly increased the period required for an in-dwelling drain (p=0.026 and p=0.037). The use of AC was significantly related to acute bleeding (p=0.044), while the use of AP was not (p=0.808). Use of AP or AC had no significant effect on CSDH recurrence (p=0.517 and p=1.000) or reoperation (p=0.924 and p=1.000). Morbidity was not statistically correlated with use of either AP or AC (p=0.795 and p=0.557, respectively), and there was no significant correlation with mortality for use of these medications (p=0.470 and p=1.000).
conclusionElderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. However, the use of AC necessitates individualized due to potential postoperative bleeding. Careful post-operative monitoring could mitigate prognosis and recurrence impacts.
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