Outcome and Prognostic Factors in Patients with Chronic Subdural Hematoma Classified According to the Initial Glasgow Coma Scale Score

Abstract

Objective: The purpose of this study was to identify the risk and prognostic factors correlated with mild to severe symptoms in patients with chronic subdural hematoma (CSDH) who underwent burr hole drainage. Methods: A total of 256 patients who had undergone burr hole drainage for CSDH were enrolled in this study. According to their Glasgow Coma Scale (GCS) score at admission, patients were divided into a "severe" (GCS<13) and a "mild" (13≤ GCS) group. Patient outcome was assessed at discharge and at a three-month follow-up using the Glasgow Outcome Scale (GOS). Results: Of the 256 patients, 36 (14.1%) were included in the "severe" group, and 220 (85.9%) in the "mild" group. In patients with severe symptoms, old age (p=0.040), end-stage renal disease (ESRD) (p=0.038), alcoholism (p=0.032), a low initial GCS score (p<0.001), and low and mixed hema-toma density (p=0.033) were more frequently observed. According to the GOS scores at discharge, more patients in the "severe" group also had ESRD (p=0.018). For the "mild" group, GOS scores indicated significant correlations with GCS score at admission (p<0.001), irrigation (p=0.037), and age (p=0.004). The GOS score at the three-month follow-up was correlated with only GCS at admission (p=0.002) in patients with mild symptoms. Conclusion: The outcome of patients with mild CSDH who underwent burr hold drainage was correlated with age, initial GCS score, and irrigation. The outcome of patients with severe CSDH was correlated only with ESRD.