■慢性硬膜下血肿(cSDH)是一种主要影响老年人的疾病。如果仅考虑70岁以上的患者,则报告的发病率范围为每100,000人年2.0/100,000至58,总体发病率为8.2-14.0/10万人。由于在2000年至2030年期间65岁以上的人口估计增加一倍,cSDH将成为甚至更重要的问题。为了获得cSDH住院率的概述,治疗,和结果,我们对需要cSDH手术治疗的患者进行了这项多中心国家队列研究.
■一项多中心队列研究纳入了2013年在瑞士认可居住中心接受治疗的患者。人口统计,病史,症状,并记录用药情况。评估入院时的影像学检查,治疗分为毛刺孔颅骨造口术(BHC),螺旋钻颅骨造口术(TDC),开颅手术.患者的结果被分为良好(mRS,0-3)和差(mRS,4-6)结果。对不成对变量进行双侧t检验,虽然对分类变量进行了卡方检验,P值<0.05被认为具有统计学意义。
■共纳入663例患者。中位年龄为76岁,总体发病率为8.2/100,000.随着年龄的增长,在80-89岁的患者中,发病率增加至64.2/100,000.362例患者中最常见的症状是步态障碍(58.6%),286例头痛(46.4%),和局灶性神经功能缺损252(40.7%)。478例(72.1%)患者的CSDH分布是单侧的,而185例出现双侧血肿,结果无差异。BHC是758例(97.3%)疏散中执行最多的程序。104例患者(20.1%)出现CSDH复发。在近81%的患者中看到了良好的结果。与不良结局相关的因素是年龄,GCS和MRS入学时,以及在诊断cSDH时出现的多种缺陷。
■作为第一个分析cSDH疾病负担的多中心国家队列研究,我们的研究表明,cSDH的入院率为8.2/100,000,而随着年龄的增长,升至64.2/10万。在81%的患者中看到了良好的结果,他们的生活质量和手术前一样。然而,死亡率为4%。
UNASSIGNED: Chronic subdural hematoma (cSDH) is a disease affecting mainly elderly individuals. The reported incidence ranges from 2.0/100,000 to 58 per 100,000 person-years when only considering patients who are over 70 years old, with an overall incidence of 8.2-14.0 per 100,000 persons. Due to an estimated doubling of the population above 65 years old between 2000 and 2030, cSDH will become an even more significant concern. To gain an overview of cSDH hospital admission rates, treatment, and outcome, we performed this multicenter national cohort study of patients requiring surgical treatment of cSDH.
UNASSIGNED: A multicenter cohort study included patients treated in 2013 in a Swiss center accredited for residency. Demographics, medical history, symptoms, and medication were recorded. Imaging at admission was evaluated, and therapy was divided into burr hole craniostomy (BHC), twist drill craniostomy (TDC), and craniotomy. Patients\' outcomes were dichotomized into good (mRS, 0-3) and poor (mRS, 4-6) outcomes. A two-sided t-test for unpaired variables was performed, while a chi-square test was performed for categorical variables, and a p-value of <0.05 was considered to be statistically significant.
UNASSIGNED: A total of 663 patients were included. The median age was 76 years, and the overall incidence rate was 8.2/100,000. With age, the incidence rate increased to 64.2/100,000 in patients aged 80-89 years. The most prevalent symptoms were gait disturbance in 362 (58.6%) of patients, headache in 286 (46.4%), and focal neurological deficits in 252 (40.7%). CSDH distribution was unilateral in 478 (72.1%) patients, while 185 presented a bilateral hematoma with no difference in the outcome. BHC was the most performed procedure for 758 (97.3%) evacuations. CSDH recurrence was noted in 104 patients (20.1%). A good outcome was seen in almost 81% of patients. Factors associated with poor outcomes were age, GCS and mRS on admission, and the occurrence of multiple deficits present at the diagnosis of the cSDH.
UNASSIGNED: As the first multicenter national cohort-based study analyzing the disease burden of cSDH, our study reveals that the hospital admission rate of cSDH was 8.2/100,000, while with age, it rose to 64.2/100,000. A good outcome was seen in 81% of patients, who maintained the same quality of life as before the surgery. However, the mortality rate was 4%.