Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!

Detalhes bibliográficos
Autor(a) principal: Silva, Danilo Otávio de Araújo
Data de Publicação: 2012
Outros Autores: Matis, Georgios K., Costa, Leonardo Ferraz, Kitamura, Matheus Augusto Pinto, Carvalho Júnior, Eduardo Vieira de, Silva, Monalisa de Moura, Barbosa, Breno José Alencar Pires, Pereira, Carlos Umberto, Silva Junior, Joacil Carlos da, Birbilis, Theodossios A., Azevedo Filho, Hildo Rocha Cirne de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFS
Texto Completo: https://ri.ufs.br/handle/riufs/2065
Resumo: Background: To present the accumulated experience from treating chronic subdural hematomas (CSDH) in a local hospital of a third world country. Methods: One hundred and twenty‑five consecutive patients with CSDH who were surgically treated in the Neurosurgical Department of the Hospital da Restauração, Recife‑PE, Brazil, between January 2006 and May 2008, were retrospectively studied. Glasgow Outcome Scale (GOS) was employed to define outcome at 6 months as good (GOS 4 and 5) or poor (GOS ≤ 3). Age, admission Glasgow Coma Scale (GCS), location of hematomas (unilateral/bilateral), drainage system placement and recurrence were all analyzed for potential impact on final outcome. Results: The median age was 69 years, with a male/female ratio of 102/23. History of trauma was present in 60.8% of the patients. The median GCS on admission was 14. In 64 patients, the hematoma was on the left side, while in 42 patients it was on the right side. Bilateral hematomas were present in 19 cases (15.2%). Drainage systems were used in 93.6% of the cases. Recurrence occurred in 8.8% of the patients. One hundred and three patients obtained a good outcome at 6 months. The mortality rate was 11.2%. Patients with GCS ≥9 on admission presented better outcome (P < 0.05). Recurrent cases presented a poor outcome (P < 0.05). Conclusions: This study suggests that the main factors associated with outcome in patients harboring CSDH are the admission GCS score and the recurrence status. Advanced age is not a contraindication for surgical treatment. This study, solely focused on the Brazilian population, is the first of its kind in the English literature, and it could serve as a useful introduction to a more complex, multivariate, debate.
id UFS-2_9226d1aad4cdd5170fd3fc7ac7d3ec97
oai_identifier_str oai:ufs.br:riufs/2065
network_acronym_str UFS-2
network_name_str Repositório Institucional da UFS
repository_id_str
spelling Silva, Danilo Otávio de AraújoMatis, Georgios K.Costa, Leonardo FerrazKitamura, Matheus Augusto PintoCarvalho Júnior, Eduardo Vieira deSilva, Monalisa de MouraBarbosa, Breno José Alencar PiresPereira, Carlos UmbertoSilva Junior, Joacil Carlos daBirbilis, Theodossios A.Azevedo Filho, Hildo Rocha Cirne de2017-06-27T22:08:25Z2017-06-27T22:08:25Z2012-12SILVA, D. O. de A. Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!. Surgical Neurology International, v. 3, n. 150, dez. 2012. Disponível em: <http://surgicalneurologyint.com/surgicalint-articles/chronic-subdural-hematomas-and-the-elderly-surgical-results-from-a-series-of-125-cases-old-horses-are-not-to-be-shot/>. Acesso em: 27 jun. 2017.2152-7806https://ri.ufs.br/handle/riufs/2065Creative Commons Attribution-NonCommercial-ShareAlike 4.0 LicenseBackground: To present the accumulated experience from treating chronic subdural hematomas (CSDH) in a local hospital of a third world country. Methods: One hundred and twenty‑five consecutive patients with CSDH who were surgically treated in the Neurosurgical Department of the Hospital da Restauração, Recife‑PE, Brazil, between January 2006 and May 2008, were retrospectively studied. Glasgow Outcome Scale (GOS) was employed to define outcome at 6 months as good (GOS 4 and 5) or poor (GOS ≤ 3). Age, admission Glasgow Coma Scale (GCS), location of hematomas (unilateral/bilateral), drainage system placement and recurrence were all analyzed for potential impact on final outcome. Results: The median age was 69 years, with a male/female ratio of 102/23. History of trauma was present in 60.8% of the patients. The median GCS on admission was 14. In 64 patients, the hematoma was on the left side, while in 42 patients it was on the right side. Bilateral hematomas were present in 19 cases (15.2%). Drainage systems were used in 93.6% of the cases. Recurrence occurred in 8.8% of the patients. One hundred and three patients obtained a good outcome at 6 months. The mortality rate was 11.2%. Patients with GCS ≥9 on admission presented better outcome (P < 0.05). Recurrent cases presented a poor outcome (P < 0.05). Conclusions: This study suggests that the main factors associated with outcome in patients harboring CSDH are the admission GCS score and the recurrence status. Advanced age is not a contraindication for surgical treatment. This study, solely focused on the Brazilian population, is the first of its kind in the English literature, and it could serve as a useful introduction to a more complex, multivariate, debate.Medknow PublicationsChronic subdural hematomaOutcomeRecurrenceSurgical treatmentChronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleengreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessTHUMBNAILChronicSubduralHematomasElderly.pdf.jpgChronicSubduralHematomasElderly.pdf.jpgGenerated Thumbnailimage/jpeg1731https://ri.ufs.br/jspui/bitstream/riufs/2065/4/ChronicSubduralHematomasElderly.pdf.jpg06b335dcfa2338577fbd5609164de568MD54ORIGINALChronicSubduralHematomasElderly.pdfChronicSubduralHematomasElderly.pdfapplication/pdf648189https://ri.ufs.br/jspui/bitstream/riufs/2065/1/ChronicSubduralHematomasElderly.pdfc92ac8fa8839d77cc80b4de3ac6bbd68MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://ri.ufs.br/jspui/bitstream/riufs/2065/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52TEXTChronicSubduralHematomasElderly.pdf.txtChronicSubduralHematomasElderly.pdf.txtExtracted texttext/plain30631https://ri.ufs.br/jspui/bitstream/riufs/2065/3/ChronicSubduralHematomasElderly.pdf.txt5337042e73e84654f53930abd03c9ac4MD53riufs/20652017-06-28 02:00:33.27oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2017-06-28T05:00:33Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false
dc.title.pt_BR.fl_str_mv Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
title Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
spellingShingle Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
Silva, Danilo Otávio de Araújo
Chronic subdural hematoma
Outcome
Recurrence
Surgical treatment
title_short Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
title_full Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
title_fullStr Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
title_full_unstemmed Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
title_sort Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!
author Silva, Danilo Otávio de Araújo
author_facet Silva, Danilo Otávio de Araújo
Matis, Georgios K.
Costa, Leonardo Ferraz
Kitamura, Matheus Augusto Pinto
Carvalho Júnior, Eduardo Vieira de
Silva, Monalisa de Moura
Barbosa, Breno José Alencar Pires
Pereira, Carlos Umberto
Silva Junior, Joacil Carlos da
Birbilis, Theodossios A.
Azevedo Filho, Hildo Rocha Cirne de
author_role author
author2 Matis, Georgios K.
Costa, Leonardo Ferraz
Kitamura, Matheus Augusto Pinto
Carvalho Júnior, Eduardo Vieira de
Silva, Monalisa de Moura
Barbosa, Breno José Alencar Pires
Pereira, Carlos Umberto
Silva Junior, Joacil Carlos da
Birbilis, Theodossios A.
Azevedo Filho, Hildo Rocha Cirne de
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Silva, Danilo Otávio de Araújo
Matis, Georgios K.
Costa, Leonardo Ferraz
Kitamura, Matheus Augusto Pinto
Carvalho Júnior, Eduardo Vieira de
Silva, Monalisa de Moura
Barbosa, Breno José Alencar Pires
Pereira, Carlos Umberto
Silva Junior, Joacil Carlos da
Birbilis, Theodossios A.
Azevedo Filho, Hildo Rocha Cirne de
dc.subject.por.fl_str_mv Chronic subdural hematoma
Outcome
Recurrence
Surgical treatment
topic Chronic subdural hematoma
Outcome
Recurrence
Surgical treatment
description Background: To present the accumulated experience from treating chronic subdural hematomas (CSDH) in a local hospital of a third world country. Methods: One hundred and twenty‑five consecutive patients with CSDH who were surgically treated in the Neurosurgical Department of the Hospital da Restauração, Recife‑PE, Brazil, between January 2006 and May 2008, were retrospectively studied. Glasgow Outcome Scale (GOS) was employed to define outcome at 6 months as good (GOS 4 and 5) or poor (GOS ≤ 3). Age, admission Glasgow Coma Scale (GCS), location of hematomas (unilateral/bilateral), drainage system placement and recurrence were all analyzed for potential impact on final outcome. Results: The median age was 69 years, with a male/female ratio of 102/23. History of trauma was present in 60.8% of the patients. The median GCS on admission was 14. In 64 patients, the hematoma was on the left side, while in 42 patients it was on the right side. Bilateral hematomas were present in 19 cases (15.2%). Drainage systems were used in 93.6% of the cases. Recurrence occurred in 8.8% of the patients. One hundred and three patients obtained a good outcome at 6 months. The mortality rate was 11.2%. Patients with GCS ≥9 on admission presented better outcome (P < 0.05). Recurrent cases presented a poor outcome (P < 0.05). Conclusions: This study suggests that the main factors associated with outcome in patients harboring CSDH are the admission GCS score and the recurrence status. Advanced age is not a contraindication for surgical treatment. This study, solely focused on the Brazilian population, is the first of its kind in the English literature, and it could serve as a useful introduction to a more complex, multivariate, debate.
publishDate 2012
dc.date.issued.fl_str_mv 2012-12
dc.date.accessioned.fl_str_mv 2017-06-27T22:08:25Z
dc.date.available.fl_str_mv 2017-06-27T22:08:25Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv SILVA, D. O. de A. Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!. Surgical Neurology International, v. 3, n. 150, dez. 2012. Disponível em: <http://surgicalneurologyint.com/surgicalint-articles/chronic-subdural-hematomas-and-the-elderly-surgical-results-from-a-series-of-125-cases-old-horses-are-not-to-be-shot/>. Acesso em: 27 jun. 2017.
dc.identifier.uri.fl_str_mv https://ri.ufs.br/handle/riufs/2065
dc.identifier.issn.none.fl_str_mv 2152-7806
dc.identifier.license.pt_BR.fl_str_mv Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License
identifier_str_mv SILVA, D. O. de A. Chronic subdural hematomas and the elderly: surgical results from a series of 125 cases: Old “horses” are not to be shot!. Surgical Neurology International, v. 3, n. 150, dez. 2012. Disponível em: <http://surgicalneurologyint.com/surgicalint-articles/chronic-subdural-hematomas-and-the-elderly-surgical-results-from-a-series-of-125-cases-old-horses-are-not-to-be-shot/>. Acesso em: 27 jun. 2017.
2152-7806
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License
url https://ri.ufs.br/handle/riufs/2065
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Medknow Publications
publisher.none.fl_str_mv Medknow Publications
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFS
instname:Universidade Federal de Sergipe (UFS)
instacron:UFS
instname_str Universidade Federal de Sergipe (UFS)
instacron_str UFS
institution UFS
reponame_str Repositório Institucional da UFS
collection Repositório Institucional da UFS
bitstream.url.fl_str_mv https://ri.ufs.br/jspui/bitstream/riufs/2065/4/ChronicSubduralHematomasElderly.pdf.jpg
https://ri.ufs.br/jspui/bitstream/riufs/2065/1/ChronicSubduralHematomasElderly.pdf
https://ri.ufs.br/jspui/bitstream/riufs/2065/2/license.txt
https://ri.ufs.br/jspui/bitstream/riufs/2065/3/ChronicSubduralHematomasElderly.pdf.txt
bitstream.checksum.fl_str_mv 06b335dcfa2338577fbd5609164de568
c92ac8fa8839d77cc80b4de3ac6bbd68
8a4605be74aa9ea9d79846c1fba20a33
5337042e73e84654f53930abd03c9ac4
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)
repository.mail.fl_str_mv repositorio@academico.ufs.br
_version_ 1802110824934801408