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Do statins reduce the rate of revision surgery after chronic subdural hematoma drain?
Johann Klein1, Lisa Mauck2, Gabriele Schackert2
1Department of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. johann.klein@uniklinikum-dresden.de.
Insights
Statins do not reduce the need for repeat surgery in patients undergoing treatment for chronic subdural hematoma (CSDH). This study found no protective effect of statins on CSDH postoperative outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Pharmacology
Background:
- Chronic subdural hematoma (CSDH) often requires surgical intervention.
- Statins show promise as primary therapy for CSDH, potentially avoiding surgery.
- The impact of statins on CSDH surgical outcomes remains unclear.
Purpose of the Study:
- To investigate the effect of statins on the rate of repeat surgery after CSDH drainage.
- To determine if statin use influences postoperative complications in CSDH patients.
Main Methods:
- Analysis of 407 patients who underwent CSDH evacuation (2012-2018).
- Comparison between patients on statins (statin group) and those not (control group).
- Review of medical records and patient/relative contact for repeat surgeries and complications.
Main Results:
- Repeat surgery was required in 21.1% of the statin group and 20.1% of the control group (p=0.81).
- Multivariate analysis showed no significant effect of statins, age, antithrombotic medication, Charlson comorbidity index, or Markwalder grading score on revision rates.
Conclusions:
- No evidence suggests statins offer a protective effect in patients undergoing CSDH surgery.
- Statin therapy is not recommended perioperatively for chronic subdural hematoma.
Background:
With chronic subdural hematoma (CSDH), surgery is the therapeutic mainstay for large or symptomatic cases. Statins are reported to be effective as the primary therapy of CSDH to obviate the need for surgery. However, the effect of statins on the postoperative course of CSDH is largely unclear. We therefore sought to determine whether statins reduce the rate of repeat surgery after CSDH drain.
Methods:
We performed an analysis of all patients who underwent surgery for CSDH at our institution between 2012 and 2018. The patients were separated into those who received statins as part of their previous medication (statin group) and those who did not (control group). The medical records were reviewed for repeat surgeries and complications. Additionally, patients or their relatives were contacted via phone to obtain missing data and inquire about possible repeat surgeries at other institutions.
Results:
We identified 407 patients who received CSDH evacuation via burr hole craniotomy. In total, 123 patients were treated with statins as part of their daily medication. Repeat surgery was performed in 26 patients in the statin group (21.1%) and 57 patients in the non-statin group (20.1%, p = 0.81). Upon multivariate logistic regression analysis, neither of the variables statins, age, antithrombotic medication, Charlson comorbidity index, or Markwalder grading score yielded a statistically significant effect upon the revision rate.
Conclusions:
We found no evidence for the protective effect of statins in patients who underwent surgery for CSDH. We thus conclude that statin therapy is not warranted for CSDH perioperatively.
