Verification of a Three-day Hospitalization Protocol for Chronic Subdural Hematoma Surgery

Area of Science:

• Neurosurgery
• Geriatric Medicine
• Healthcare Management

Background:

• Chronic subdural hematoma (CSH) predominantly affects the elderly, with increasing incidence in aging populations.
• Healthcare systems face challenges managing rising CSH cases and associated costs.
• A three-day hospitalization protocol was implemented to optimize bed management and reduce expenses.

Purpose of the Study:

• To investigate clinical factors influencing prolonged hospitalization after CSH surgery.
• To evaluate the safety and efficacy of a shortened, three-day hospitalization protocol for CSH.

Main Methods:

• A retrospective analysis of 221 consecutive patients undergoing CSH irrigation, evacuation, and drainage from January 2015 to December 2020.
• Statistical analysis using the chi-squared test and logistic regression to identify predictors of prolonged hospitalization.
• Defining prolonged hospitalization based on deviations from the three-day protocol.

Main Results:

• The three-day hospitalization protocol demonstrated no adverse outcomes for CSH patients.
• Twenty-four percent (52/221) of patients experienced prolonged hospitalization.
• Factors significantly associated with prolonged hospitalization included female gender, atrial fibrillation, alcohol abuse, preoperative consciousness level, verbal function disturbance, and activities of daily living.

Conclusions:

• The three-day hospitalization protocol for CSH is a viable and safe approach for patient care.
• Female gender, atrial fibrillation, and alcohol abuse are significant clinical factors necessitating focused attention to manage prolonged hospital stays.
• Further research may explore targeted interventions for high-risk patient groups to optimize recovery and reduce hospitalization duration.