Evidence map›Paper›PMID 38956812›Full record

ArticleBrain and behavior2024

Additional treatment after primary conservative treatment in patients with chronic subdural hematoma-A retrospective study.

Rahman Fakhry, Clemens M F Dirven, Walid Moudrous, S Mirjam Droger, Nabil Asahaad, Christiaan de Brabander, Hester F Lingsma, Niels A van der Gaag, Heleen M den Hertog, Bram Jacobs and 3 more

Abstract read
In one paragraph

Article in Brain and behavior, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

13 authors.

Rahman FakhryDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, The Netherlands.ORCID 0000-0003-3040-6522
Clemens M F DirvenDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, The Netherlands.
Walid MoudrousDepartment of Neurology, Maasstad Hospital, Rotterdam, The Netherlands.
S Mirjam DrogerDepartment of Neurology, Maasstad Hospital, Rotterdam, The Netherlands.
Nabil AsahaadDepartment of Neurology, Van Weel Bethesda Hospital, Dirksland, The Netherlands.
Christiaan de BrabanderDepartment of Neurology, Admiraal de Ruyter Hospital, Goes, The Netherlands.
Hester F LingsmaDepartment of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Niels A van der GaagUniversity Neurosurgical Center Holland (UNCH), Leiden University Medical Center, Haaglanden Medical Center, Haga Teaching Hospital, Leiden, The Netherlands.
Heleen M den HertogDepartment of Neurology, Isala Hospital Zwolle, Zwolle, The Netherlands.
Bram JacobsDepartment of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Korné JellemaDepartment of Neurology, Haaglanden Medical Center, The Hague, The Netherlands.
Ruben DammersDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, The Netherlands.
Dana C HollDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, The Netherlands.ORCID 0000-0001-7514-8825

Funding

Erasmus Medisch Centrum 2016-16118ZonMw 843002824
6 · The paper itself

Abstract

objectiveChronic subdural hematoma (CSDH) is a common neurological condition and is typically treated with burr hole craniostomy. Nevertheless, conservative treatment may lead to spontaneous hematoma resolution in some patients. This study aims to describe the characteristics of patients who were treated conservatively without the eventual need for additional treatment.

methodsData were retrospectively collected from patients who were primarily treated conservatively in three hospitals in the Netherlands from 2008 to 2018. The Primary outcome was the nonnecessity of additional treatment within 3 months after the initial CSDH diagnosis. We used univariable and multivariable logistic regression analyses to identify factors associated with not receiving additional treatment.

resultsIn this study, 83 patients were included and 61 patients (73%) did not receive additional treatment within 3 months. Upon first presentation, the patients had a Markwalder Grading Scale score (MGS) of 0 (n = 5, 6%), 1 (n = 43, 52%), and 2 (n = 35, 42%). Additional treatment was less often received by patients with smaller hematoma volumes (adjusted odds ratio [aOR] 0.78 per 10 mL; 95% confidence interval [CI] 0.64-0.92). Patients using antithrombotic medication also received less additional treatment, but this association was not significant (aOR 2.02; 95% CI 0.61-6.69).

conclusionsThree quarters of the initially conservatively treated CSDH patients do not receive additional management. Typically, these patients have smaller hematoma volumes. Further, prospective research is needed to distinguish which patients require surgical intervention and in whom primary conservative treatment suffices.

Indexed as

Conservative TreatmentHematoma, Subdural, ChronicAgedAged, 80 and overFemaleHumansMaleMiddle AgedNetherlandsRetrospective StudiesconservativeCSDHtreatment

Identifiers

PMID38956812
PMCPMC11219291

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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.