Evidence map›Paper›PMID 38554149›Full record

ArticleJournal of neurology2024

Factors associated with success of conservative therapy in chronic subdural hematoma: a single-center retrospective analysis.

Merijn Foppen, Roger Lodewijkx, Harssh Verdan Bandral, Kevin Yah, K Mariam Slot, William Vandertop, Dagmar Verbaan

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

Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 15% 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

6 citing papers in PubMed, 5 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

7 authors at 1 institution in 1 country.

Merijn FoppenDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.foppen@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-3657-6007
Roger LodewijkxDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-0365-6745
Harssh Verdan BandralDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0009-0003-1640-1394
Kevin YahDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
K Mariam SlotDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-5680-5620
William VandertopDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-5417-0265
Dagmar VerbaanDepartment of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-9212-5470
Amsterdam Neuroscience · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionConservative therapy is a viable option for patients with chronic subdural hematoma (cSDH) who express no, or only mild symptoms. It is not clear which factors are associated with success of conservative therapy. This study aims to determine conservative therapy's success rate and to identify features possibly associated with success.

methodsA monocenter retrospective cohort study, including cSDH patients treated conservatively (wait-and-watch) from 2012 to 2022, was performed. The primary outcome was success of conservative therapy, defined as 'no crossover to surgery' during the follow-up period. Secondary outcomes were (1) factors associated with success, analyzed with univariate and multivariable logistic regression analyses, (2) 30-day mortality (3) time to crossover and (4) reasons for crossover.

resultsWe included 159 patients. Conservative therapy was successful in 96 (60%) patients. Hematoma volume (OR 0.79, 95% CI 0.69-0.92) and hypodense hematoma type (OR 3.57, 95% 1.38-9.23) were associated with success. Thirty-day mortality rate was 5% and the median duration between diagnosis and surgery was 19 days (IQR 8-39). Clinical deterioration was the most frequent reason for crossover (in 61/63 patients, 97%) and was accompanied by radiological hematoma progression in 42 patients (67%).

conclusionIn this selected group of patients, conservative therapy was successful in 60%. Smaller hematoma volume and hypodense hematoma type were associated with success. As time until crossover was approximately three weeks, deploying conservative therapy as primary treatment seems safe and could be rewarding as surgical complications can be avoided. Improvement in patient selection in future cohorts remains warranted.

Indexed as

Conservative TreatmentHematoma, Subdural, ChronicAgedAged, 80 and overFemaleHumansMaleMiddle AgedOutcome Assessment, Health CareRetrospective StudiesTreatment OutcomeChronicCohort studiesConservative treatmentHematomaHumansRetrospective studiesSubdural

Identifiers

PMID38554149
PMCPMC11136764
OpenAlexW4393343107

What Socratic holds

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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 Socratic graph.