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Intravenous fluid administration may improve post-operative course of patients with chronic subdural hematoma: a

Miroslaw Janowski1, Przemyslaw Kunert

  • 1Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland. mjanows1@jhmi.edu

Plos One
|April 26, 2012
PubMed

Insights

Intravenous fluid administration (IFA) is a key factor in preventing chronic subdural hematoma (cSDH) recurrence. Administering at least 2000 ml over three days post-surgery can significantly lower recurrence rates.

Area of Science:

  • Neurosurgery
  • Clinical Medicine
  • Patient Management

Background:

  • Chronic subdural hematoma (cSDH) treatment carries a high risk of recurrence.
  • Postoperative management strategies, particularly intravenous fluid administration (IFA), are understudied in cSDH.
  • Limited research exists on the impact of IFA on cSDH outcomes.

Purpose of the Study:

  • To investigate the impact of postoperative intravenous fluid administration (IFA) on chronic subdural hematoma (cSDH) recurrence.
  • To identify patient management factors influencing hematoma recurrence and neurological outcomes.

Main Methods:

  • Retrospective analysis of 45 cSDH patients treated with burr hole craniostomy and closed drainage.
  • Independent variables included various patient management aspects, focusing on IFA.
  • Dependent variables were hematoma recurrence rate (RHR) and Glasgow Outcome Scale (GOS) at discharge.

Main Results:

  • Hematoma recurrence requiring re-operation occurred in 15% of patients.
  • Univariate analysis showed IFA duration significantly impacted RHR (p=0.045) and GOS (p=0.023).
  • Multivariate analysis identified IFA as the sole independent predictor of RHR. Patients receiving ≥2000 ml/day over 3 days had lower RHR (p=0.031).

Conclusions:

  • Intravenous fluid administration (IFA) is a critical, independent factor influencing both cSDH recurrence and patient neurological outcomes.
  • A recommended postoperative IFA regimen of at least 2000 ml per 3 days may reduce cSDH recurrence risk.
Abstract

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