Evidence map›Paper›PMID 40175597›Full record

ArticleNeurosurgical review2025

Impact of surgical timing on chronic subdural hematoma outcomes: novel insights from a multicenter study.

Stefano Colonna, Enrico Lo Bue, Alessandro Pesaresi, Lorenzo Dolci, Andrea Gatto, Luca Ceroni, Alessandro Pesce, Maurizio Salvati, Daniele Armocida, Alessandro Frati and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurosurgical review, 2025. 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. Observational
  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

14 authors.

Stefano ColonnaDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy. stefano.colonna@unito.it.ORCID http://orcid.org/0009-0004-4576-3260
Enrico Lo BueDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy.
Alessandro PesaresiDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy.
Lorenzo DolciDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy.
Andrea GattoDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy.
Luca CeroniDepartment of Psychology, University of Turin, Turin, Italy.
Alessandro PesceDepartment of Neurosurgery, University of Rome "Tor Vergata", Rome, Italy.
Maurizio SalvatiDepartment of Neurosurgery, University of Rome "Tor Vergata", Rome, Italy.
Daniele ArmocidaDepartment of Neurosurgery, A.O. Ospedale Maggiore Parma, Parma, Italy.
Alessandro FratiNeurosurgery, IRCCS Neuromed, Pozzilli, Italy.
Antonio SantoroHuman Neurosciences Department, Neurosurgery Division, "Sapienza" University, Rome, Italy.
Alice MistrettaDepartment of Intensive care unit and Emergency, CTO Hospital, A.O.U. "Città della Salute e della Scienza, Turin, Italy.
Diego GarbossaDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy.
Fabio CofanoDepartment of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Via Cherasco, 15, Turin, 10126, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveChronic Subdural Hematoma (CSDH) is one of the most frequently encountered conditions in the neurosurgical practice. The role of timing in CSDH surgery in mild symptomatic patients remains uncertain. The aim of this study was to analyze the prognostic role of surgical timing in patients with mild symptomatic CSDH.

methodsIn this multicenter retrospective study, patients diagnosed with mild symptomatic CSDH who underwent surgical evacuation were enrolled. Marwalder Grading System (MGS) and GCS scores were used for neurological evaluation. Patients presenting with preoperative GCS score ≥ 13 and MGS score ≤ 2 scores were defined as "mild symptomatic". A ROC curve analysis was used to identify the optimal surgical timing associated with favorable postoperative outcome. Univariate and multivariate analysis were used to verify the association between surgical timing and postoperative neurological outcome, length of hospitalization, and postoperative complication.

resultsA total of 160 patients were enrolled in the study. The mean latency from hospital admission to surgical intervention was 2.5 ± 3.2 days. All patients treated with surgical evacuation demonstrated postoperative clinical improvement in terms of GCS and/or MGS scores. The univariate and multivariate analyses demonstrated significantly better neurological outcomes and shorter length of hospitalization in patients treated within 3 days from hospital admission. No statistically significant associations were demonstrated between surgical timing and postoperative complication.

conclusionsThis is the first study to identify a specific surgical timing cut-off in the treatment of mildly symptomatic CSDH associated with improved clinical outcomes and recovery, offering a potential reference point for clinical decision-making. Patients who underwent surgery within three days from hospital admission exhibited significantly better postoperative neurological outcomes and shorter hospital stays. Surgical timing did not influence postoperative complications, including hematoma recurrence or the need for early reintervention.

Indexed as

Hematoma, Subdural, ChronicNeurosurgical ProceduresAgedAged, 80 and overFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsPrognosisRetrospective StudiesTime FactorsTime-to-TreatmentTreatment OutcomeChronic subdural hematomaMild symptomaticMulticenter studySurgical timing

Identifiers

PMID40175597
PMCPMC11965206

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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.